Tumor-associated collagen signatures: pushing tumor boundaries

In 2006, a new model of invasive breast tumor emerged and, since 2011, is gaining recognition and research momentum. "Tumor-associated collagen signatures" describe 3 distinct layers of collagen which radiate outward in shells from the main body of the tumor. The outermost layer (TACS3) features branches of collagen radiating away from the tumor, 90° perpendicular to the tumor surface. TACS3 increases tumor span and correlates directly with metastasis, though presently difficult to detect in breast tissue. TACS is an emerging model but has been validated by multiple labs in vitro and in vivo, specifically for breast cancer prognostics. Newly recognized and accepted tumor borders will impact both R0 resections and downstream surgical reconstruction. This review aims to comprehensively introduce and connect the ranging literature on linearized collagen of invasive tumor borders. Using PubMed keyword searches containing "aligned," "linear," "oriented," and "organized," we have gathered the studies on TACS, integrated the concept into the clinic, and projected future platforms.