Skip to main content
. Author manuscript; available in PMC: 2014 Jun 1.
Published in final edited form as: Surgery. 2013 Mar 13;153(6):771–778. doi: 10.1016/j.surg.2013.02.002

FIGURE 3. Primary tumor resection in metastatic breast cancer significantly prolongs survival despite the observed Fisher and Folkman effects.

FIGURE 3

(A) Study design: Twenty-four mice ten days after implantation with 1×105 4T1-luc2 cells were randomized to Observation (Obs), Resection of primary tumor (Resect), and Resection of the contralateral mammary gland (Sham) groups (N = 8 per group). (B) Overall tumor burden was quantified by bioluminescence. There was no statistical difference in overall tumor burden between the groups at the time of randomization. Tumor burden was significantly higher in the Sham group (thin line) compared to the Obs group (bold line) on day 12 (Fisher effect (black arrow), #P < .001), but there was no significant difference by day 29. The rate of increase in tumor burden was significantly faster after removal of the primary tumor (Resect group (dotted line); *P < .05, **P < .001, ***P <. 001), with a slope of 11.4 and 4.7 in the Resect group compared to 4.2 and 1.7 in the Obs group (Folkman effect (white arrow)). (C) Kaplan-Meier analysis demonstrates a significant improvement in survival after resection (dotted line) vs. Sham (thin line) (P < .01) and vs. Obs (bold line) (P = .01). No difference in survival was observed between the Sham and Obs groups.