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While survival of early\u2010stage breast cancer patients has increased dramatically, the 5\u2010year survival rate of metastatic patients has barely improved in the last 20\u2009years. Metastases can arise up to decades after primary tumor resection, hinting at microenvironmental factors influencing the sudden outgrowth of disseminated tumor cells (DTCs). This review summarizes how the environment of the most common metastatic sites (lung, liver, bone, brain) is influenced by the primary tumor and by the varying dormancy of DTCs, with a special focus on how established metastases persist and grow in distant organs due to feed\u2010forward loops (FFLs). We discuss in detail the importance of FFL of cancer cells with their microenvironment including the secretome, interaction with specialized tissue\u2010specific cells, nutrients\/metabolites, and that novel therapies should target not only the cancer cells but also the tumor microenvironment, which are thick as thieves.<\/jats:p>","DOI":"10.15252\/emmm.202114283","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T04:54:44Z","timestamp":1651640084000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Feed\u2010forward loops between metastatic cancer cells and their microenvironment\u2014the stage of escalation"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0796-5011","authenticated-orcid":false,"given":"Zora","family":"Baumann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9059-8979","authenticated-orcid":false,"given":"Priska","family":"Auf der Maur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6344-1127","authenticated-orcid":false,"given":"Mohamed","family":"Bentires\u2010Alj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"BFEMMM202114283_CR1","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.cell.2014.07.013","volume":"158","author":"N Aceto","year":"2014","unstructured":"Aceto N, Bardia A, Miyamoto D, Donaldson M, Wittner B, Spencer J, Yu M, Pely A, Engstrom A, Zhu H et al (2014) Circulating tumor cell clusters are oligoclonal precursors of breast cancer metastasis. 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