How does a cancer develop ?

Cancer does not always develop as we imagine, in a linear and inevitable way from one cell toward generalization and then the death.
The model that has been taught for a long time was that of a cell which becomes out of control, multiplies in an uncontrolled way, becomes a tumor in an organ, spreads in a local-regional manner, and then generally leads fatally to the death of the organism if no intervention is made.

HOW DOES A BREAST CANCER DEVELOP?


Modern scientific evidence, epidemiological studies and autopsy studies enable us to design other models for the development of breast cancer. (click on pictures)

We have now learned that breast cancer does not develop in a linear manner, but that there are a multitude of possibilities, with slow, even nonprogressive cancers, which, if they are unknown, will not impact a person's life or health; some may even regress, while others may evolve quite fast, and are intrinsically immediately aggressive, due to their molecular characteristics, they are the ones that lead to a true cancer-disease.

The diagrams below explain why screening has failed, with several types of cancer developments.

  • Rapidly developing, intrinsically aggressive cancer has a high velocity and a short residence time in the organ, it will be missed by screening. Metastases are often present, even if not yet visible, in lymph nodes or distant organs. It is often big at the time of diagnosis, because it is fast, being found big does not mean late diagnosis.
  • Very slow, nonprogressive or regressive cancer, which would not have impacted the patient's life, has a very long residence time in the organ and will therefore rather be detected by repeated screening. Its diagnosis is useless for the patient, yet it will be treated with the same aggressiveness. It is small at the time of diagnosis because it is slow; small does not necessarily mean "early".
  • The cancer which develops progressively will one day be symptomatic and detected by the patient by the appearance of a clinical sign, this cancer can be treated in time, because the evolution towards the generalization stage takes a very long time (10, 20 to 30 years).

Click on pictures

Having a cancerous tumor does not automatically lead to a cancer-disease. However, this is what women are made to believe by telling them that they have been cured thanks to the detection of a tumor that would never have killed them. On the other hand, the rate of serious cancers has not decreased since the screening in place.