Epistemología del cáncer de mama: Comprendiendo su origen para anticipar su desenlace

  • Rusvelt Franklin Vargas Universidad de Cartagena
  • Haroldo Estrada López Universidad de Cartagena
  • Josefina Zakzuk Sierra Universidad de Cartagena
  • Nelson Alvis Guzmán Grupo de Investigación en Economía de la Salud-GIES; Universidad de Cartagena. Grupo de investigación en gestión hospitalaria y políticas de salud-Universidad de la Costa.
Palabras clave: Epistemología, cáncer de mama, historia, modelos


El cáncer de mama es uno de los de mayor incidencia y mortalidad a nivel mundial. Es necesario comprender su historia natural a través de una mirada epistemológica, integrando modelos clínicos, filosóficos y matemáticos, para poder abordar una visión general del mismo, cómo se ha interpretado a lo largo de la historia, y el aporte que los estudios de detección y ensayos clínicos han dado los tratamientos que reciben los pacientes, mostrando evidencia científica e histórica que pueda ser empleada como bitácora por parte de clínicos, salubristas y público en general.


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Biografía del autor/a

Rusvelt Franklin Vargas, Universidad de Cartagena
M.D MscDoctorate Student.Universidad de Cartagena, GIES (Grupo de Investigación en Economía de la Salud)


(1) Strohman R. The coming Kuhnian revolution in biology. Nature Biotechnology 1997;15(3): 194-200.

(2) DeSantis C, Ma J, Brayan L, Jemal A. Breast cancer statistics, 2013. CA: a cancer journal for clinicians, 2014; 64 (1): 52-62.

(3) Mitchell S. 2009. Unsimple Truths. Science, Complexity and Policy, Chicago: The University of Chicago

(4) Marcos A. Filosofia dell’agire scientifico, Milano: Academia Universa Press, 2010.

(5) Anderson W. Pathology, Volume One. 6th edition. St. Louis: The CV Mosby Company; 1971

(6) Howard W, Schultz O. Studies in the Biology of Tumor Cells. New York: The Rockefeller Institute of Medical Research; 1911.

(7) Tomlinson I, Novelli M, Bodmer W: The mutation rate and cancer. Proc Natl Acad Sci USA 1996;93(25):14800–14803.

(8) Vogelstein B, Kinzler K. Cancer genes and the pathways they control. Nat Med 2004; 10(8):789–799.

(9) Hanahan D, Weinberg R: Hallmarks of cancer: the next generation. Cell 2011, 144(5):646–674.

(10) Pisani P, Parkin D, Muñoz N, Ferlay J. Cancer and infection: estimates of the attributable fraction in 1990. Cancer Epidemiol Biomarkers Prev 1997, 6(6):387–400.

(11) Bertolaso M. The two sides of the hourglass: analytic and synthetic approaches in cancer research. Ludus Vitalis, 2011; 19 (35): 73-95.

(12) Soto A, Sonnenschein C. Systems biology and cancer. Progress in Biophysics and Molecular Biology, 2011; 106(2): 337–339.

(13) Sandison A. Letter: Kanam mandible's tumour. Lancet, 1975; 1(7901):279.

(14) Strouhal E. Ancient Egyptian case of carcinoma. Bull. N. Y. Acad. Med. 1978 Mar;54(3):290-302.

(15) Diamandopoulos G. Cancer: an historical perspective. Anticancer Res, 1996; 16(4A):1595-602.

(16) Karpozilos A, Pavlidis N. The treatment of cancer in Greek antiquity. Eur. J. Cancer, 2004; 40(14):2033-40.

(17) Salaverry O. La etimología del cáncer y su curioso curso histórico. Revista Peruana de Medicina Experimental y Salud Pública, 2013; 30 (1) 137-141.

(18) Ariel I, Cleary J. Breast Cancer Diagnosis and Treatment. New York, McGraw-Hill, 1987: 3-26.

(19) Wood W: Progress from clinical trials on breast cancer. Cancer, 1994; 74 (S9): 2606-2609.

(20) Weiss L. Metastasis of cancer: a conceptual history from antiquity to the 1990s. Cancer Metastasis Rev, 2000;19(3-4): 193-383.

(21) Olson A, James Stuart. Bathsheba's breast: women, cancer & history. Baltimore. 2012. The Johns Hopkins University Press. p. 11

(22) Donaldson I. The Cyrurgia of Albucasis and other works, 1500. J R Coll Physicians Edinb, 2011; 41(1):85-8.

(23) Bakay L. The treatment of head injuries in the Thirty Years' War, 1618-1648: Joannis Scultetus and his age. Thomas, 1971.

(24) Hajdu S Medieval pathfinders in surgical oncology. Cancer, 2004;101(5):879-82.

(25) Serrano J. De Paracelso a la medicina moderna: donde la química y la física van de la mano. An. Quím, 2011; 107(4): 398–403

(26) Ekmektzoglou K, Xanthos T, German V, Zografos G. Breast cancer: from the earliest times through to the end of the 20th century." European Journal of Obstetrics & Gynecology and Reproductive Biology, 2009; 145(1): 3-8.

(27) Kardinal C, Yarbro J. A conceptual history of cancer. Semin. Oncol, 1979; 6(4):396-408.

(28) Martensen R. Cancer: medical history and the framing of a disease. JAMA, 1994; 271(24): 1901.

(29) Ellis, H. (2005). The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery. Bmj, 330(7488), 425.

(30) Stone M, Aronoff B, Evans W, Fay J, Lieberman Z, Matthews C, Race G, Scruggs R, Stringer C. History of the Baylor Charles A. Sammons Cancer Center. Proc (Bayl Univ Med Cent), 2003; 16(1):30-58.

(31) Virchow R: Cellular Pathology. Philadelphia, JB Lippincott, 1863

(32) Halsted W. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to January 1894. AM Surg 20(5):497-555.

(33) Brinkley D, Haybittle J. The curability of breast cancer. The Lancet 1975; 306(7925): 95-97

(34) Woods L, Rachet B, Lambert P, Coleman M. Cure from breast cancer amongst two populations of women followed for twenty-three years after diagnosis. Ann Oncol, 2009; 20(8):1331–6.

(35) Blichert-Toft M, Rose C, Anderson J, Overgaard M, Axelsson C, Andersen K, Mouridsen, H. Danish randomized trial comparing breast conservative therapy with mastectomy. J Natl Cancer Inst Monogr, 1992; 11(1):19-25.

(36) Gunduz N, Fisher 8, Saffer E: Effect of surgical removal on the growth and kinetics of residual tumor. Cancer Res, 1979; 39(10):3861-3865.

(37) O'Reilly M, Holmbren L, Shing Y, Chen C, Rosenthal R, Moses M, Folkman J. Angiostatin: A novel angiogenesis inhibitor that mediates the suppression of metastases by a Lewis lung carcinoma. Cell, 1994; 79(2):315-328

(38) Atkins H, Hayward J, Klugman D, Wayte A. Treatment of early breast cancer: a report after ten years of a clinical trial. Br. Med. J, 1972; 2(5811):423-9.

(39) Fisher B. Biological research in the evolution of cancer surgery: a personal perspective. Cancer Res, 2008; 68(24):10007-20.

(40) Overgaard M, Hansen P, Overgaard J, Rose C, Andersson M, Bach F, Zedeler K. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med, 1997;337(14):949–55.

(41) Vaidya J, Joseph D, Tobias JS, Bulsara M, Wenz F, Saunders C, Keshtgar M. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. The Lancet, 2010;376(9735):91-102.

(42) Langlands A. Prognostic factors and the curability of breast cancer. ANZ J Surg, 1995; 65 (9):630-633.

(43) Le M, Hill C, Rezvani A, Sarrazin D, Contesso G, Lacour J. Long-term survival of women with breast cancer. The Lancet, 1984; 324(8408), 922.

(44) Jatoi I. Breast Cancer Screening. Austin, TX, Landes Bioscience, 1997, pp 35-49

(45) Van Netten J, Ross A, Cann S, Derry D, Smith M. Is breast cancer a progressive or systemic disease? The Lancet, 1995; 345(8945): 319-320.

(46) Nielsen M, Thomsen J, Primdahl S, Dyreborg U, Andersen J. Breast cancer and atypia among young and middle aged women: A study of 110 medicolegal autopsies. Br J Cancer, 1987; 56(6): 814.

(47) Howard D, Tangka K, Royalty J, Dalzell L, Miller J, O’Hara B, Hall I (2015). Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998–2012. Cancer Causes & Control, 26(5), 657-668.

(48) Gadgil A, Sauvaget C, Roy N, Muwonge R, Kantharia S, Chakrabarty A, et al. Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India. The Breast, 2017; 31(1):85-89

(49) Early Breast Cancer Trialists collaborative Group: Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy, The Lancet, 1992; 339 (8784):1-15.

(50) Ginseng G, Lauer J, Zelle S, Baeten S, Baltussen R. Cost effectiveness of strategies to combat breast, cervical, and colorectal cancer in Sub-Saharan Africa and South East Asia: Mathemetical modelling study. BMJ. 2012; 344:e614–e614.

(51) The American Cancer Society. Breast Cancer Prevention and Early Detection. 2014. En: http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs-bse. Fecha de acceso: Agosto de 2017

(52) Okobia MN, Bunker CH, Okonofua FE, Osime U. Knowledge, attitude and practice of Nigerian women towards breast cancer: A cross-sectional study. World J. Surg. Oncol. 2006; 4:11.

(53) Shapiro S: Periodic Screening for Breast Cancer: the Health Insurance Plan Project and its Sequelae, 1963-1986. Baltimore, Johns Hopkins University Press, 198

(54) Hassan L, Mahmoud N, Miller A, Iraj H, Mohsen M, Majid J, Mojgan, M. (2015). Evaluation of effect of self-examination and physical examination on breast cancer. The Breast, 24(4), 487-490.

(55) Game J, Edwards M. Parametric models of therapeutic efficacy in breast cancer. N Engl J Med, 1996; 344(19):1270-1271,

(56) Fisher B: Personal contributions io progress in breast cancer research and treatment. Semin Oncol, 1996; 23(4):414-427,

(57) Hellman S. Karnofsky Memorial Lecture. Natural history of small breast cancers. J Clin Oncol, 1994; 12(10); 2229-2234,

(58) Fisher B, Redmond C, Fisher E, Bauer M, Wolmark N, Wickerham D, Foster R. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med, 1985; 312(11):674-681.

(59) Jacobson JA, Cowan KH, D’Angelo T, Steinberg S, Pierce L, Okunieff P. Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and I1 breast cancer. N Engl J Med, 1995; 332(14): 907-911.

(60) Sarrazin D, Le M, Arriagada R, Contesso G, Fontaine F, Spielmann M, Lacour J. Ten years results of a randomized trial comparing conservative treatment to mastectomy in early breast cancer. Radiother Oncol, 1989; 14(3):177- 184.

(61) McGuire K, Santillan A, Kaur P, et al. Are mastectomies on the rise? a 13-year trend analysis of the selection of mastectomy versus breast conservation therapy in 5865 patients. Ann Surg Oncol. 2009;16(10):2682-2690.

(62) Smith G, Xu Y, Shih Y, et al. Breast-conserving surgery in older patients with invasive breast cancer: current patterns of treatment across the United States. J Am Coll Surg. 2009;209(4): 425.e2-433.e2.

(63) Agarwal S, Pappas L, Neumayer L, Kokeny K, Agarwal J. (2014). Effect of breast conservation therapy vs mastectomy on disease-specific survival for early-stage breast cancer. JAMA surgery, 149(3), 267-274.

(64) Ragaz J, Jackson S, Le N, Plenderleith I, Spinelli J, Basco V, Coldman A. Adjuvant radiotherapy and chemotherapy in nodepositive premenopausal women with breast cancer. N Engl J Med, 337956-962

(65) Hellman S. Stopping metastases at their source. N Engl J Med, 1997; 337:996-997,

(66) Stewart TH Postmastectomy radiotherapy: More than a local matter. The Lancet, 1994; 344:351,

(67) Folkman J, Watson K, Ingber D, Hanahan D. Induction of angiogenesis during the transition from hyperplasia to neoplasia. Nature 1989; 339(6219): 58-61

(68) Folkman J. Angiogenesis in cancer, vascular, rheumatoid and other disease. Nature Medicine 1995, 1, 21-31.

(69) Folkman J. Tumour angiogenesis. En Mendelson J, Howley PM, Israel MA, Liota LA, eds. The Molecular Basis of Cancer. Philadelphia, WB Swanders, 1995, 206-232.

(70) Holmgren L, O'Reilly M, Folkman J. Dormancy of micrometastases: balanced proliferation and apoptosis in the presence of angiogenesis suppression. Nature Medicine 1995, 1, 149-153

(71) Baum M, Chaplain M, Anderson A, Douek M, Vaidya J. Does breast cancer exist in a state of chaos? European journal of cancer, 1999; 35(6): 886-891.

(72) Hynes R. Fibronectins. New York, Springer-Verlag, 1990

(73) Demaria S, Pikarsky E, Karin M, et al. Cancer and inflammation: promise for biologic therapy. J Immunother 2010;33(4):335–51

(74) Baum M, Budzar A, Cuzick J, et al. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 2002;359:2131–9

(75) Pellegrini I, Rapti M, Extra J, et al. Tailored chemotherapy based on tumour gene expression analysis: breast cancer patients’ misinterpretations and positive attitudes. Eur J Cancer Care, 2012; 21(2):242–50

(76) Bauer K: Mutationstheorie der Geschwulst-Entstehung. Berlin: Julius Springer Verlag; 1928

(77) Watson J, Crick F. Molecular structure of nucleic acids; a structure for deoxyribose nucleic acid. Nature 1953; 171(4356):737–738.

(78) Cobb M: 1953: when genes become “information”. Cell 2013, 153(3):503–506.

(79) Ashley D. The two “hit” and multiple “hit” theories of carcinogenesis. Br J Cancer 1969, 23(2):313–328

(80) Fearon E, Vogelstein B: A genetic model for colorectal tumorigenesis. Cell 1990; 61(5):759–767.

(81) Hanahan D, Weinberg R: The hallmarks of cancer. Cell, 2000; 100(1):57–70.

(82) Cleaver J. Photosensitivity brings light to a new transcription-coupled DNA repair cofactor. Nat Genet, 2012; 44(5):447–478.

(83) Rosenfeld S. Are the somatic mutation and tissue organization field theories of carcinogenesis incompatible? Cancer Inform 2013, 12:221–229.

(84) Versteeg R: Cancer: tumours outside the mutation box. Nature, 2014; 506(7489):438–439.

(85) Mack S, Witt H, Piro R, Gu L, Zuyderduyn S, Stütz A, et al: Epigenomic alterations define lethal CIMP-positive ependymomas of infancy. Nature 2014, 506(7489):445–450.

(86) Parker M, Mohankumar K, Punchihewa C, Weinlich R, Dalton J, Li Y, Lee R, et al: C11orf95-RELA fusions drive oncogenic NF-κB signalling in ependymoma. Nature 2014; 506(7489):451–455.

(87) Roche B, Sprouffske K, Hbid H, Missé D, Thomas F. Peto’s paradox revisited: theoretical evolutionary dynamics of cancer in wild populations. Evol Appl, 2013; 6(1):109–116.

(88) Kim E, Fang X, Fushan A, Huang Z, Lobanov A, Han L, y cols. Genome sequencing reveals insights into physiology and longevity of the naked mole rat. Nature, 2011; 479(7372):223–227.

(89) Vogelstein B, Papadopoulos N, Velculescu V, Zhou S, Diaz L, Kinzler K. Cancer genome landscapes. Science, 2013; 339(6127):1546–1558.

(90) Tomasetti C, Vogelstein B, Parmigiani G: Half or more of the somatic mutations in cancers of self-renewing tissues originate prior to tumor initiation. Proc Natl Acad Sci USA, 2013; 110(6):1999–2004.

(91) Grivennikov S, Greten F, Karin M: Immunity, Inflammation, and Cancer. Cell, 2010; 140(6):883–899.

(92) Da Cunha A. Genetic analysis of the polymorphism of color pattern in Drosophila polymorphia. Evolution, 1949; 3(3):239–251

(93) Slavkin H, Greulich R. Extracellular Matrix Influences on Gene Expression. New York: Academic Press Inc; 1975:833

(94) Mecham R, Madaras J, Senior R. Extracellular matrix-specific induction of elastogenic differentiation and maintenance of phenotypic stability in bovine ligament fibroblasts. J Cell Biol, 1984; 98(5):1804–1812.

(95) Zhe X, Cher M, Bonfil R. Circulating tumor cells: finding the needle in the haystack. Am J Cancer Res, 2011; 1(6):740–751.

(96) Brücher B, Jamall I. Epistemology of the origin of cancer: a new Paradigm. BMC Cancer, 2014: 14:331

Cómo citar
Vargas, R.F., Estrada López, H., Zakzuk Sierra, J. y Alvis Guzmán, N. 2021. Epistemología del cáncer de mama: Comprendiendo su origen para anticipar su desenlace. Revista Colombiana de Cancerología. 25, 2 (abr. 2021). DOI:https://doi.org/10.35509/01239015.129.
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