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Genetic and kinetic factors in the drug resistance of micrometastatic disease.
Of all of the potential scenarios described above the last is perhaps the most pessimistic or at least the one which will require the greatest advances in understanding and modulating tumor cell behaviour. If this type of phenomenon is indeed the basis of treatment failure in stage II breast cancer then it will be difficult to demonstrate this directly by any of the techniques currently available. If consistent application of the strategies dictated by other treatment failure scenarios fail to yield progressively improving results then one might have to infer this more pessimistic situation indirectly. This carries with it the implication that ultimate and truly satisfactory control of micro-metastatic breast cancer will have to await further fundamental discoveries involving the growth parameters and properties of tumor cells during the time when they exist as small isolated colonies.
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