Host-Related Factors in the Interplay among Inflammation, Immunity and Dormancy in Breast Cancer Recurrence and Prognosis - An Overview for Clinicians

Sep 24, 2026

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A significant proportion of early breast cancer patients later develop medium-term and late distant recurrence, with delayed metastatic emergence defined as dormancy. The review explains clinical latency in isolated metastatic cancer cells as a complex, host-influenced interaction between disseminated tumor cells and their microenvironment. It highlights inflammation and immunity as key regulators, with guidance for clinicians on biological dormancy mechanisms, immune response involvement, and host-related factors that can affect systemic inflammation and immune dynamics, shaping breast cancer dormancy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages23

Reading Time58 min

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Introduction

Clinical latency and distant recurrence

Biological basis of dormancy

Disseminated cancer cells and metastatic niches

Dormant cancer cells and immune interactions

Review Host-Related Factors in the Interplay among Inﬂammation, Immunity and Dormancy in Breast Cancer Recurrence and Prognosis: An Overview for Clinicians Lorenzo Ruggieri 1, Anna Moretti 2, Rossana Berardi 3, Maria Silvia Cona 1, Davide Dalu 1, Cecilia Villa 1, Davide Chizzoniti 1, Sheila Piva 4, Anna Gambaro 1 and Nicla La Verde 1, * Citation: Ruggieri, L.; Moretti, A.; Berardi, R.; Cona, M.S.; Dalu, D.; Villa, C.; Chizzoniti, D.; Piva, S.; Gambaro, A.; La Verde, N. HostRelated Factors in the Interplay among Inﬂammation, Immunity and Dormancy in Breast Cancer Recurrence and Prognosis: An Overview for Clinicians. Int. J. Mol. Sci. 2023, 24, 4974. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/ijms24054974](10.3390/ijms24054974) Academic Editors: Marco Erreni and Diletta Di Mitri Received: 1 February 2023 Revised: 28 February 2023 Accepted: 2 March 2023 Published: 4 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Medical Oncology Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Via G.B. Grassi, n􀀎 74, 20157 Milan, Italy 2 Medical Oncology Unit, S. Carlo Hospital, ASST Santi Paolo e Carlo, 20153 Milan, Italy 3 Department of Oncology, Universit Politecnica delle Marche—AOU delle Marche, 60121 Ancona, Italy 4 Medical Oncology Unit, Fatebenefratelli Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy * Correspondence: [laverde.nicla@asst-fbf-sacco.it](laverde.nicla@asst-fbf-sacco.it); Tel.: +39-02-3904-2492 Abstract: A signiﬁcant proportion of patients treated for early breast cancer develop mediumterm and late distant recurrence. The delayed manifestation of metastatic disease is deﬁned as“dormancy”. This model describes the aspects of the clinical latency of isolated metastatic cancer cells. Dormancy is regulated by extremely complex interactions between disseminated cancer cells and the microenvironment where they reside, the latter in turn inﬂuenced directly by the host. Among these entangled mechanisms, inﬂammation and immunity may play leading roles. This review is divided into two parts: the ﬁrst describes the biological underpinnings of cancer dormancy and the role of the immune response, in particular, for breast cancer; the second provides an overview of the host-related factors that may inﬂuence systemic inﬂammation and immune response, subsequently impacting the dynamics of breast cancer dormancy. The aim of this review is to provide physiciansand medical oncologists a useful tool to understand the clinical implications of this relevant topic. Keywords: dormancy; dormant; breast cancer; inﬂammation; immune escape; host-related factors; lifestyle 1. Introduction Breast cancer (BC) is the most common type of cancer in women and represents one of the most important concerns for global health [1,2] . A signiﬁcant proportion of patients experience distant recurrence despite having received curative treatment for early-stage disease. Tumor characteristics (such as stage at diagnosis, biological subtype and site of metastasis) and patient characteristics (such as age, body mass index (BMI) and menopausal status) mainly determine the risk of distant recurrence and pattern of relapse [3,4] . Late distant relapse is a speciﬁc characteristic of BC, occurring even 20 years after the deﬁnitive treatment for localized or locally advanced disease [5,6] . In this regard, the improvement in the risk of recurrence and cancer-speciﬁc mortality due to the extension of adjuvant endocrine therapy in hormone-positive BC is probably related to the prolongation of the interval of metastatic latency [7,8] . To date, the biological basis of clinic

FAQs

What does “dormancy” mean in breast cancer recurrence?

Dormancy refers to the delayed manifestation of metastatic disease, where isolated metastatic cancer cells remain clinically undetectable for a period before resuming growth.

How is cancer dormancy linked to inflammation and immunity?

The model emphasizes that inflammation and immunity may play leading roles through complex interactions among disseminated cancer cells, the microenvironment, and the host immune response.

Which factors does the review discuss as host-related influences on dormancy?

It provides an overview of host-related factors that may influence systemic inflammation and immune response, which in turn impact the dynamics of breast cancer dormancy.

Sep 24, 2026

Uploaded by Jiven