Breast cancer patients are expected to be able to predict the risk of tumor recurrence and metastasis by measuring the expression of a cytokine in their bodies before tumor removal surgery. Recently, the Breast Cancer Center at Sun Yat-Sen Memorial Hospital of Sun Yat-sen University discovered a new mechanism for breast cancer metastasis, and the results were published in the May 12 issue of ancerC ell, a leading international oncology journal. The study indicates that breast cancer tumor cells and their “soil” environment have a vicious circle effect that promotes each other’s growth, thus contributing to the metastasis of the tumor; later treatment can greatly reduce the risk of breast cancer metastasis by cutting off any part of this circle mechanism. The average age of breast cancer patients in China is 10 years younger than in Europe and the United States. Breast cancer is the most prevalent malignancy among women worldwide, with one woman diagnosed with breast cancer every three minutes. The incidence of breast cancer in China is increasing at an annual rate of 3-4%, which exceeds the world average growth rate. The average age of onset of breast cancer in China is around 45 years old, which is lower than the age of 55 years old in Europe and the United States. Liu Qiang introduced that, according to previous reports, the mortality rate of urban breast cancer patients in China increased by nearly 40% during the seven years from 2003 to 2009; data released by the National Cancer Center in 2009 showed that the incidence of breast cancer in China’s tumor registration areas ranked first among female malignant tumors. Breast cancer metastasis is the main cause of death for patients “But the main cause of death for breast cancer patients is not breast cancer itself, but breast cancer metastasis to other parts of the body.” Liu Qiang said that the mortality rate of breast cancer does not rank first, and at present, the early cure rate of breast cancer is high, with 60% to 70% of patients being curable in the early stage, and the remaining 30% to 40% will have recurrence or metastasis. Therefore, to treat breast cancer, it is very important to master its tumor metastasis mechanism. Professor Song Erwei, Vice President of Sun Yat-Sen Memorial Hospital, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University and the leader of breast surgery, introduced that tumor is equivalent to “seed” and microenvironment is equivalent to “soil”. The study is to reveal the interaction between the “seed” and the “soil” of breast cancer. The most inflammatory cells in the soil of breast cancer are macrophages, which are activated to help the “seeds” grow, said Song. The key to activation is a cytokine called GM-CSF, which is released by the seeds. Liu Qiang said, breast cancer cells should be epithelial cells, but some tumor cells will undergo epithelial-mesenchymal transition, this transformation makes the original round tumor cells into long shuttle-shaped, “the activity is stronger, more likely to metastasize.” At the same time the transformed tumor cells then secrete this GM-CSF cytokine. ”GM-CSF will ‘buy’ the macrophages in the soil, so that they start to serve the tumor cells now.” The tumor cells and the “renegade” macrophages will snowball, and the end result is that the breast cancer metastasizes to other parts of the body, Liu said. The first author of the article, Dr. Shicheng Su, an attending physician at the Department of Breast Oncology, Sun Yat Sen Memorial Hospital, Sun Yat-sen University, said they found that blocking the function of GM-CSF or CCL18 could inhibit the metastasis of breast cancer cells. Clinical Implications Changing the “soil” provides new ideas for treatment Song Erwei said, “Once the mechanism of the malignant cycle of breast cancer is clear, interrupting any of the links can greatly reduce the chance of breast cancer metastasis.” In terms of treatment, the focus has once been on combating the tumor cells themselves, but less on the soil in which they live. “How do you modify the soil? This study of ours offers a new therapeutic idea.” This provides the basis for future trials to open up targeted drugs against breast cancer soil, Songerwei said. It may take two to three years or more to roll out to clinical diagnosis because of the need to go through a rigorous clinical trial process, while it will take 10-15 years or more for targeted drugs to develop and become clinically widespread, Songerwei said.