Metastasis Mechanisms

A 58-year-old Indian female with a 3 cm breast carcinoma (ER+, PR+, HER2−) undergoes mastectomy. Pathology reveals lymphovascular invasion (LVI) with tumor cells within vascular spaces. Six months later, she develops bone metastases in the spine and femur. Which of the following best explains the mechanism by which lymphovascular invasion facilitates metastasis in this patient?

Which of the following mechanisms best explains how tumor cells evade the epithelial-mesenchymal transition (EMT) checkpoint and acquire the ability to invade and migrate through the extracellular matrix?

A 52-year-old Indian male presents with progressive dyspnea and chest pain for 3 months. Chest X-ray shows a 4 cm left lower lobe mass with pleural effusion. CT chest reveals the primary tumor and multiple nodules in the right lung and liver. Histopathology of the primary lesion shows adenocarcinoma with high expression of vimentin and loss of E-cadherin on immunohistochemistry. Which of the following molecular mechanisms best explains the propensity of this tumor to metastasize?

Which of the following adhesion molecules is primarily responsible for the initial attachment of circulating tumor cells to the vascular endothelium during the process of metastasis?