Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: new findings and a review.

To explain a bimodal pattern of hazard of relapse among early stage breast cancer patients identified in multiple databases, we proposed that late relapses result from steady stochastic progressions from single dormant malignant cells to avascular micrometastases and then on to growing deposits. However in order to explain early relapses, we had to postulate that something happens at about the time of surgery to provoke sudden exits from dormant phases to active growth and then to detection. Most relapses in breast cancer are in the early category.

Promising development from translational or perhaps anti-translational research in breast cancer.

Background: A great deal of the public's money has been spent on cancer research but demonstrable benefits to patients have not been proportionate. We are a group of scientists and physicians who several decades ago were confronted with bimodal relapse patterns among early stage breast cancer patients who were treated by mastectomy. Since the bimodal pattern was not explainable with the then well-accepted continuous growth model, we proposed that metastatic disease was mostly inactive before surgery but was driven into growth somehow by surgery.

NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup.

To explain a bimodal relapse hazard among early stage breast cancer patients treated by mastectomy we postulated that relapses within 4 years of surgery resulted from something that happened at about the time of surgery to provoke sudden exits from dormant phases to active growth. Relapses at 10 months appeared to be surgery-induced angiogenesis of dormant avascular micrometastases. Another relapse mode with peak about 30 months corresponded to sudden growth from a single cell.

Serious life-threatening complication 5 years after laparoscopic totally extraperitoneal hernia repair: case report and discussion of the literature.

Purpose: The purpose of this paper is to report the case of a serious life-threatening infection of the mesh occurring 5 years after totally extraperitoneal (TEP) hernia repair and to highlight the persistent risk of infection that may exist even after a long period following the primary repair. We also aim to raise the awareness of surgeons to the subtle presentation.

Methods: We have reviewed the clinical presentation, past medical history and relevant pre-operative and post-operative investigations in a case of mesh infection 5 years after primary surgery.