In 1991, Judah
Folkman emphasized the 'angiogenic switch' hypothesis for tumor progression.
Studies have showed that angiogenesis positively correlates with the degree of
metastasis, tumor recurrence and shorter survival rates, thereby demonstrating
the value of angiogenesis as a prognostic cancer marker. Tumor angiogenesis is
similar to physiological angiogenesis; however, latter proceeds in an
uncontrolled and excessive manner giving rise to leaky and tortuous vessels
that are in a constant state of inflammation. As the malignant breast mass
grows, tumor cells secrete peptide growth factors, which promote angiogenesis.
Angiogenesis, in turn, provides the tumor mass with nutrients essential to
sustain growth. In theory, the altered hemodynamics that accompany tumor angiogenesis
provide the basis for discriminating between malignant and benign masses of the
breast by color Doppler sonography. Lack of smooth muscle in the arteriolar
wall and absence of a normal capillary bed results in modified end-organ
resistance and arteriovenous shunting.
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