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. 1994 Mar;69(3):566–571. doi: 10.1038/bjc.1994.103

Tumour cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up.

N Harbeck 1, M Untch 1, L Pache 1, W Eiermann 1
PMCID: PMC1968873  PMID: 7510120

Abstract

We examined bone marrow aspirates from 100 metastasis-free primary breast cancer patients. In 38/100 patients (38%), tumour cells were detected in the marrow using an immunocytochemical technique with a cocktail of two monoclonal antibodies: anti-EMA and anti-cytokeratin. Median follow-up was 34 months: 15/38 (39%) tumour cell-positive patients have since relapsed, but only 9/62 (15%) tumour cell-negative patients. The median interval between tumour cell detection and relapse was 11.4 months. No statistically significant correlation existed between tumour cell presence and 'established' prognostic factors. However, relapse-free survival was significantly shorter in tumour cell-positive patients. Multivariate analysis showed tumour cell presence as a strong, significant prognostic factor for relapse-free as well as overall survival. We conclude that screening for tumour cells in bone marrow of primary breast cancer patients identifies high-risk patients for early relapse. In particular, patients with node-negative tumours who have tumour cells in their bone marrow may require subsequent systemic therapy.

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Selected References

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  1. Berger U., Bettelheim R., Mansi J. L., Easton D., Coombes R. C., Neville A. M. The relationship between micrometastases in the bone marrow, histopathologic features of the primary tumor in breast cancer and prognosis. Am J Clin Pathol. 1988 Jul;90(1):1–6. doi: 10.1093/ajcp/90.1.1. [DOI] [PubMed] [Google Scholar]
  2. Cote R. J., Rosen P. P., Lesser M. L., Old L. J., Osborne M. P. Prediction of early relapse in patients with operable breast cancer by detection of occult bone marrow micrometastases. J Clin Oncol. 1991 Oct;9(10):1749–1756. doi: 10.1200/JCO.1991.9.10.1749. [DOI] [PubMed] [Google Scholar]
  3. Dearnaley D. P., Sloane J. P., Ormerod M. G., Steele K., Coombes R. C., Clink H. M., Powles T. J., Ford H. T., Gazet J. C., Neville A. M. Increased detection of mammary carcinoma cells in marrow smears using antisera to epithelial membrane antigen. Br J Cancer. 1981 Jul;44(1):85–90. doi: 10.1038/bjc.1981.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Diel I. J., Kaufmann M., Costa S. D., Kaul S., Krempien B., Goerner R., Bastert G. Prognostische Bedeutung des Tumorzellnachweises im Knochenmark von Patientinnen mit Mammakarzinom. Geburtshilfe Frauenheilkd. 1990 Dec;50(12):923–928. doi: 10.1055/s-2008-1026393. [DOI] [PubMed] [Google Scholar]
  5. Diel I. J., Kaufmann M., Goerner R., Costa S. D., Kaul S., Bastert G. Detection of tumor cells in bone marrow of patients with primary breast cancer: a prognostic factor for distant metastasis. J Clin Oncol. 1992 Oct;10(10):1534–1539. doi: 10.1200/JCO.1992.10.10.1534. [DOI] [PubMed] [Google Scholar]
  6. Ellis G., Ferguson M., Yamanaka E., Livingston R. B., Gown A. M. Monoclonal antibodies for detection of occult carcinoma cells in bone marrow of breast cancer patients. Cancer. 1989 Jun 15;63(12):2509–2514. doi: 10.1002/1097-0142(19890615)63:12<2509::aid-cncr2820631225>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  7. Epithelial membrane antigen and lymphoid cells. Lancet. 1985 Jan 12;1(8420):109–110. [PubMed] [Google Scholar]
  8. Fisher B., Redmond C., Fisher E. R. The contribution of recent NSABP clinical trials of primary breast cancer therapy to an understanding of tumor biology--an overview of findings. Cancer. 1980 Aug 15;46(4 Suppl):1009–1025. doi: 10.1002/1097-0142(19800815)46:4+<1009::aid-cncr2820461326>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  9. Funke I., Fries S., Jauch K. W. Tumorzellnachweis im Knochenmark: Entscheidungshilfe zur adjuvanten Therapie bei nodal-negativen Patientinnen mit Mammacarcinom. Konzept einer Multicenterstudie und Ergebnisse der Pilotphase. Chirurg. 1991 Nov;62(11):805–809. [PubMed] [Google Scholar]
  10. Henderson I. C., Canellos G. P. Cancer of the breast: the past decade (first of two parts). N Engl J Med. 1980 Jan 3;302(1):17–30. doi: 10.1056/NEJM198001033020104. [DOI] [PubMed] [Google Scholar]
  11. Mansi J. L., Berger U., Easton D., McDonnell T., Redding W. H., Gazet J. C., McKinna A., Powles T. J., Coombes R. C. Micrometastases in bone marrow in patients with primary breast cancer: evaluation as an early predictor of bone metastases. Br Med J (Clin Res Ed) 1987 Oct 31;295(6606):1093–1096. doi: 10.1136/bmj.295.6606.1093. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mansi J. L., Berger U., McDonnell T., Pople A., Rayter Z., Gazet J. C., Coombes R. C. The fate of bone marrow micrometastases in patients with primary breast cancer. J Clin Oncol. 1989 Apr;7(4):445–449. doi: 10.1200/JCO.1989.7.4.445. [DOI] [PubMed] [Google Scholar]
  13. Mansi J. L., Easton D., Berger U., Gazet J. C., Ford H. T., Dearnaley D., Coombes R. C. Bone marrow micrometastases in primary breast cancer: prognostic significance after 6 years' follow-up. Eur J Cancer. 1991;27(12):1552–1555. doi: 10.1016/0277-5379(91)90413-8. [DOI] [PubMed] [Google Scholar]
  14. McGuire W. L., Abeloff M. D., Fisher B., Glick J. H., Henderson I. C., Osborne C. K. Adjuvant therapy in node-negative breast cancer. A panel discussion. Breast Cancer Res Treat. 1989 Mar;13(2):97–115. doi: 10.1007/BF01806522. [DOI] [PubMed] [Google Scholar]
  15. McGuire W. L., Tandon A. K., Allred D. C., Chamness G. C., Clark G. M. How to use prognostic factors in axillary node-negative breast cancer patients. J Natl Cancer Inst. 1990 Jun 20;82(12):1006–1015. doi: 10.1093/jnci/82.12.1006. [DOI] [PubMed] [Google Scholar]
  16. Porro G., Ménard S., Tagliabue E., Orefice S., Salvadori B., Squicciarini P., Andreola S., Rilke F., Colnaghi M. I. Monoclonal antibody detection of carcinoma cells in bone marrow biopsy specimens from breast cancer patients. Cancer. 1988 Jun 15;61(12):2407–2411. doi: 10.1002/1097-0142(19880615)61:12<2407::aid-cncr2820611202>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  17. Redding W. H., Coombes R. C., Monaghan P., Clink H. M., Imrie S. F., Dearnaley D. P., Ormerod M. G., Sloane J. P., Gazet J. C., Powles T. J. Detection of micrometastases in patients with primary breast cancer. Lancet. 1983 Dec 3;2(8362):1271–1274. doi: 10.1016/s0140-6736(83)91150-9. [DOI] [PubMed] [Google Scholar]
  18. Ridell B., Landys K. Incidence and histopathology of metastases of mammary carcinoma in biopsies from the posterior iliac crest. Cancer. 1979 Nov;44(5):1782–1788. doi: 10.1002/1097-0142(197911)44:5<1782::aid-cncr2820440536>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  19. Schlimok G., Funke I., Holzmann B., Göttlinger G., Schmidt G., Häuser H., Swierkot S., Warnecke H. H., Schneider B., Koprowski H. Micrometastatic cancer cells in bone marrow: in vitro detection with anti-cytokeratin and in vivo labeling with anti-17-1A monoclonal antibodies. Proc Natl Acad Sci U S A. 1987 Dec;84(23):8672–8676. doi: 10.1073/pnas.84.23.8672. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Segal M. R., Bloch D. A. A comparison of estimated proportional hazards models and regression trees. Stat Med. 1989 May;8(5):539–550. doi: 10.1002/sim.4780080503. [DOI] [PubMed] [Google Scholar]
  21. Thor A., Viglione M. J., Ohuchi N., Simpson J., Steis R., Cousar J., Lippman M., Kufe D. W., Schlom J. Comparison of monoclonal antibodies for the detection of occult breast carcinoma metastases in bone marrow. Breast Cancer Res Treat. 1988 May;11(2):133–145. doi: 10.1007/BF01805837. [DOI] [PubMed] [Google Scholar]
  22. Untch M., Harbeck N., Eiermann W. Micrometastases in bone marrow in patients with breast cancer. Br Med J (Clin Res Ed) 1988 Jan 23;296(6617):290–290. doi: 10.1136/bmj.296.6617.290. [DOI] [PMC free article] [PubMed] [Google Scholar]

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