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. 2017 Jan 1;10(1):3–14. doi: 10.1242/dmm.025049

Fig. 1.

Fig. 1.

Progression of events during metastatic disease. Cancer cells follow a series of steps during the course of metastatic disease, potentially invading as individuals or as clusters of cells. At the start of metastatic progression, tumor cells dissociate and locally invade tissue surrounding a primary tumor. Invasive tumor cells can eventually intravasate across the endothelial barrier and circulate through the bloodstream. Rarely, a small subset of circulating tumor cells will extravasate back across the endothelial barrier into distant tissue. At these secondary sites, another small subset of colonies will further adapt to the new secondary site and proliferate to form new macroscopic tumor sites.