Minimal Residual Disease in Breast Cancer, Methods of Its Detection, Treatment and Can It Prevent Metastasis?

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Abstract
Breast cancer is the most common cancer in women, depending on the sub-type of breast cancer treatment options are different. After completing advujant therapy, there may relapse even many years later. This review examines the tumour microenvironment, cancer cells do not exist alone but are a small part of the tumour microenvironment, described as an ecosystem. This includes stromal cells, immunosuppressive regulatory T-cells, myeloid derived suppression cells, cancer associated fibroblasts, tumour associated macrophages. The balance of the immunosuppressive tumour microenvironment and the anti-tumour immune response will determine if there is a future relapse. Most therapeutic options involve therapies directed against tumour cells, only in the last few years has there been attention on the effects of the tumour microenvironment on disease progression and the possibility of decreasing the risk of metastatic disease. This article reviews the latest development in preventing metastatic disease by influencing the tumour microenevironment; at best eliminating cancer cells or at least prolonging the latent period of cancer cell dormancy.

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