Background: Results of long-term studies justify that the rate of breast cancer recurrence
and tumor-related mortality remains quite unpredictable, regardless of the use of any current therapeutic
Objective: Since the application of standard therapies, such as surgery, radiation, chemotherapy and
antiestrogen administration does not work as might be expected; our therapeutic practice requires
Method: Published long-term therapeutic results on breast cancer cases were analyzed in correlation with stage at diagnosis,
ER-status of tumors and patients’ age. The effectiveness of current therapeutic measures was also compared by estimating
the rate of tumor-free survival, breast cancer recurrence and breast cancer-specific mortality.
Results: Diagnosis and treatment of breast cancer at an early stage cannot improve the rate of tumor-free survival. Poor
differentiation of tumors, ER-negativity in particular, defines poor prognosis even after applying aggressive therapies. In
patients treated with in situ breast cancer, the recurrence-rate of invasive tumor increased directly with ageing irrespective
of tumor size or ER-status at diagnosis. Women who underwent lumpectomy without adjuvant radiation or chemotherapy
exhibited significantly better overall and breast cancer specific survival rates than those receiving mastectomy, regardless
of stage and ER-status of tumors. Antiestrogen treatment exhibited unforeseeable effectiveness even on targeted ERpositive
tumors. Recent patents propose the detection of ESR1-gene amplification or restoration of ER-alpha expression
for prediction of effective antiestrogen treatment, suggesting a crucial inhibitory role of estrogen-signaling against tumorgrowth.
Conclusion: Estradiol-induced upregulation of estrogen signaling coupled with sparing of the estrogen-rich mammary
fatpad are the most effective strategies against breast cancer.