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Detection of cancer before distant metastasis

Overview of attention for article published in BMC Cancer, June 2013
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Title
Detection of cancer before distant metastasis
Published in
BMC Cancer, June 2013
DOI 10.1186/1471-2407-13-283
Pubmed ID
Authors

Frank AW Coumans, Sabine Siesling, Leon WMM Terstappen

Abstract

BACKGROUND: To establish a distant metastasis (DM) cells must disseminate from the primary tumor and overcome a series of obstacles, the metastatic cascade. In this study we develop a mathematical model for this cascade to estimate the tumor size and the circulating tumor cell (CTC) load before the first metastasis has formed from a primary breast cancer tumor. METHODS: The metastatic cascade is described in discrete steps: 1. local tumor growth; 2. dissemination into circulation; 3. survival in circulation; 4. extravasation into tissue; and 5. growth into a metastasis. The model was built using data and relationships described in the literature to predict the relationship between tumor size and probability of distant metastasis for 38715 patients with surgically removed TXNXM0 primary breast cancer from the Netherlands Cancer Registry. The model was calibrated using primary tumor size, probability of distant metastasis and time to distant metastasis for 1489 patients with stage T1BNXM0 (25% of total patients with T1BNXM0). Validation of the model was done with data for all patients. RESULTS: From the time to distant metastasis of these 38715 breast cancer patients, we determined a tumor doubling time of 1.7 +/- 0.9 months. Fitting the data for 25% of T1B patients estimates a metastatic efficiency of 1 metastasis formed per 60 million disseminated tumor cells. Validation of the model to data of patients in all T-stages shows good agreement between model and epidemiological data. To reduce the 5-year risk of distant metastasis for TXNXM0 from 9.2% to 1.0%, the primary tumor needs to be detected and removed before it reaches a diameter of 2.7 +/- 1.6 mm. At this size, the model predicts that there will be 9 +/- 6 CTC/L blood. CONCLUSIONS: To reduce the rate of distant metastasis in surgically treated TXNXM0 breast cancer to 1%, imaging technology will need to be able to detect lesions of 2.7 mm in diameter or smaller. Before CTC detection can be applied in the early disease setting, sensitivity will need to be improved by at least 15-fold and combined with technology that minimizes false positives.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 88 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 2 2%
United States 1 1%
India 1 1%
Unknown 84 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 19 22%
Student > Ph. D. Student 15 17%
Other 10 11%
Student > Master 10 11%
Student > Bachelor 7 8%
Other 15 17%
Unknown 12 14%
Readers by discipline Count As %
Medicine and Dentistry 30 34%
Agricultural and Biological Sciences 17 19%
Biochemistry, Genetics and Molecular Biology 11 13%
Engineering 5 6%
Mathematics 2 2%
Other 7 8%
Unknown 16 18%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 July 2013.
All research outputs
#18,341,369
of 22,713,403 outputs
Outputs from BMC Cancer
#5,419
of 8,265 outputs
Outputs of similar age
#147,944
of 196,882 outputs
Outputs of similar age from BMC Cancer
#69
of 85 outputs
Altmetric has tracked 22,713,403 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,265 research outputs from this source. They receive a mean Attention Score of 4.3. This one is in the 21st percentile – i.e., 21% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 196,882 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 12th percentile – i.e., 12% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 85 others from the same source and published within six weeks on either side of this one. This one is in the 10th percentile – i.e., 10% of its contemporaries scored the same or lower than it.