Adjuvant clodronate treatment improves the overall survival of primary breast cancer patients with micrometastases to bone marrow - a longtime follow-up

In 125 early breast cancer patients who underwent multiple bone marrow aspirates, there was no significant difference in terms of disease-free and overall survival after a median follow-up of 163 months between the patients with or without micrometastasis at the time of primary surgery. However, when the time-dependent evolution of the bone marrow aspirates was taken into account, some evidence for a longer disease-free and overall survival was found for the patients with negative bone marrow

Download Full-text

Micrometastases to bone marrow in primary breast cancer patients – A long time follow up in 1256 patients

Zentralblatt für Gynäkologie ◽

10.1055/s-2004-828869 ◽

2004 ◽

Vol 126 (03) ◽

Author(s):

F Schuetz ◽

S Kalteisen ◽

EF Solomayer ◽

G Bastert ◽

S Costa ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Cancer Patients ◽

Primary Breast Cancer ◽

Breast Cancer Patients ◽

Long Time

Download Full-text

Micrometastases to bone marrow in primary breast cancer patients – A long time follow up in 1256 patients

Zentralblatt für Gynäkologie ◽

10.1055/s-2004-829745 ◽

2004 ◽

Vol 126 (03) ◽

Author(s):

F Schuetz ◽

S Kalteisen ◽

EF Solomayer ◽

G Bastert ◽

S Costa ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Cancer Patients ◽

Primary Breast Cancer ◽

Breast Cancer Patients ◽

Long Time

Download Full-text

The fate of bone marrow micrometastases in patients with primary breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1989.7.4.445 ◽

1989 ◽

Vol 7 (4) ◽

pp. 445-449 ◽

Cited By ~ 110

Author(s):

J L Mansi ◽

U Berger ◽

T McDonnell ◽

A Pople ◽

Z Rayter ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Adjuvant Therapy ◽

Cancer Patients ◽

Primary Breast Cancer ◽

Breast Cancer Patients ◽

Initial Surgery ◽

Definitive Surgery

Using an immunocytochemical technique, micrometastases have been found in the bone marrow of approximately 26% of patients with primary breast cancer at the time of initial surgery. To determine the fate of these cells, both in patients receiving and not receiving adjuvant therapy, multiple bone marrow aspirates were repeated in 82 patients at a median time of 18 months after surgery but prior to overt relapse. In both treated and untreated patients micrometastases were only found in one of 45 (2%) and one of 37 (3%) patients, respectively. However, when multiple marrow aspirates were taken from patients with local recurrence the incidence of micrometastases was 19% (three of 16), and this increased to 30% (three of ten) in patients with disease at distant sites other than bone, and 100% (ten of ten) in patients with radiologically proven bony disease. Three of 11 (27%) patients in whom the primary tumor remained in situ while receiving adjuvant therapy before definitive surgery had micrometastases at the time of diagnosis and at follow-up 3 months later. These results suggest that many of the micrometastases from breast cancer patients are the result of "shedding" of cells from the primary carcinoma and that a proportion are not viable. The technique is currently insufficiently sensitive to accurately monitor adjuvant therapy in breast cancer patients.

Download Full-text

Prognostic Significance of Isolated Tumor Cells (ITC) in the Bone Marrow (BM) of Breast Cancer Patients During Recurrence-free Follow-up and Therapeutic Intervention with Zoledronate

Zentralblatt für Gynäkologie ◽

10.1055/s-2005-921013 ◽

2005 ◽

Vol 127 (04) ◽

Author(s):

B Rack ◽

W Janni ◽

C Schindlbeck ◽

B Strobl ◽

T Blankenstein ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Cancer Patients ◽

Tumor Cells ◽

Therapeutic Intervention ◽

Prognostic Significance ◽

Breast Cancer Patients ◽

Isolated Tumor Cells

Download Full-text

Estrogen receptor (ER) status of disseminated tumor cells in the bone marrow of breast cancer patients

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.21013 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 21013-21013

Author(s):

F. N. Tanja ◽

N. Krawczyk ◽

D. Wallwiener ◽

S. Becker ◽

E. Solomayer

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Cancer Patients ◽

Tumor Cells ◽

Primary Tumor ◽

Hormone Receptor ◽

Primary Breast Cancer ◽

Disseminated Tumor Cells ◽

Breast Cancer Patients ◽

Primary Tumors

21013 Background: The presence of disseminated tumor cells (DTC) in bone marrow (BM) of primary breast cancer patients is associated with poor prognosis. These patients may benefit from adjuvant endocrine therapy since cytotoxic agents are not able to completely eliminate DTCs as previously shown. Only patients with hormone receptor positive breast cancer are eligible for hormonal treatment. The ERa status is routinely defined in primary tumor tissue. However, the ERa status of DTC may differ compared to the primary tumor. Therefore, the aims of this study were (1) to determine the ERa status of DTC in BM of breast cancer patients, (2) and to compare the ERa status of DTC and corresponding primary tumors. Methods: BM aspirates from 251 primary breast cancer patients were included into the study. A double immunofluorescence staining procedure was established for the identification of cytokeratin-positive (CK)/ERa positive cells. ERa status of the primary tumor was immunohistochemically assessed using the same antibody against ERa. Results: In 105 of 251 (42%) breast cancer patients CK-positive cells could be detected in BM. The number of detected cells ranged between 1 and 13 / cells per 2*106 mononuclear cells. Disseminated tumor cells demonstrated ERa positivity in 13 (12%) of these 105 patients. The ERa expression on DTC was heterogeneous in 10 of 13 (79%) patients. Concordance rate of ERa status between primary tumor and DTC was 27%. Only 11 of 83 patients with ER a positive tumors had also ERa positives DTC. Conclusions: (1)The hormone receptor status between primary tumor and corresponding DTC is disconcordant. (2)This discrepancy may explain the rate of non-responders to adjuvant endocrine therapy despite ER-positive primary tumors. (3)These patients may benefit from adjuvant therapy regimens based on antibody strategies or bisphosphonates. No significant financial relationships to disclose.

Download Full-text