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Mizejewski. J Cancer Metastasis Treat 2019;5:35 Journal of Cancer
DOI: 10.20517/2394-4722.2018.70 Metastasis and Treatment

Review Open Access

Breast cancer, metastasis, and the
microenvironment: disabling the tumor cell-to-

stroma communication network

Gerald J. Mizejewski

Wadsworth Center, New York State Department of Health, Albany, NY 12201-0509, USA.
Correspondence to: Dr. Gerald J. Mizejewski, Division of Translational Medicine, Molecular Diagnostics Laboratory, Wadsworth
Center, New York State Department of Health, P.O. Box 509, Empire State Plaza, Albany, NY 12201-0509, USA.
E-mail: gerald.mizejewski@health.ny.gov

How to cite this article: Mizejewski GJ. Breast cancer, metastasis, and the microenvironment: disabling the tumor cell-to-stroma
communication network. J Cancer Metastasis Treat 2019;5:35. http://dx.doi.org/10.20517/2394-4722.2018.70

Received: 30 Oct 2018 First Decision: 25 Jan 2019 Revised: 6 Feb 2019 Accepted: 7 Mar 2019 Published: 21 Apr 2019
Science Editor: William Schiemann Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Breast cancer (BC) is the leading cause of cancer-related deaths in women worldwide. However, the majority of
cancer mortalities can be attributed to cancer cell metastasis to distal organs/tissues rather than the primary tumor
mass itself. The microenvironment surrounding the main tumor mass, as well as its final migration destination, plays
a crucial role in the survival, growth, proliferation, and progression of BC. Intercellular stromal cells and components
of the microenvironment surrounding a tumor comprise a nurturing cubicle that provides a communication network
of cross-talk and signaling between the tumor cells and the extracellular matrix (ECM) and interstitial cells. This
network connection enables the tumor cells to engage in metastatic-associated activities such as cell adhesion,
invasiveness, mobility, migration, cell shape change, cell-to-cell contact, and basement membrane degradation. An
untapped therapeutic approach that might disable the communication network between cancer and stromal cells
could possibly aid in providing this unmet need in treating metastatic disease. The intravenous administration of
select protein-derived peptides to patients might have the potential to occupy, saturate, and block receptors and
binding proteins at the interstitial/ECM communication interface with tumors.

Keywords: Alpha-fetoprotein, cancer, metastasis, breast, microenvironment, interstitium, extra-cellular matrix, stroma

INTRODUCTION
Breast cancer (BC) and its metastasis are worldwide public health issues causing financial, economic, social,
and personal lifestyle problems in addition to their high mortality rate. An increased metastatic potential in
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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