Time independence of the prognostic impact of tumor cell detection in the bone marrow of primary breast cancer patients.
OBJECTIVE
Tumor cell detection (TCD) in bone marrow is an outstanding prognostic factor in breast cancer. There is only one other study that has investigated more than 300 patients with a median follow-up of more than 5 years (J. L. Mansi et al., Lancet, 354:197-202, 1999). We report data from 727 patients with a median follow-up period of 6.5 years.


METHODS
In a prospective study, intraoperatively aspirated bone marrow was screened for micrometastatic cancer cells. We used an immunocytological method (monoclonal mucin antibody 2E11; the avidin-biotin complex method).


RESULTS
Forty-three percent of the patients were TCD positive. Sixty percent of the patients with distant metastases were tumor cell positive (155 of 258 patients). Forty-nine percent of the patients with positive TCD developed distant metastases (155 of 315 patients). TCD was an independent prognostic factor for clinical outcome after a median follow-up time of 6.5 years. The prognostic impact of TCD and tumor size remains constant with the time, whereas the impact of grading and progesterone receptor on risk seems to decrease with longer follow-up time.


CONCLUSIONS
TCD remains an independent prognostic factor The impact of TCD does not change with longer follow-up time. TCD is a reliable prognostic factor and provides important information about the process of metastasis.
Solomayer
E F
EF
Department of Obstetrics and Gynecology, University of Tübingen, Schleichstrasse 4, 72076 Tübingen, Germany. erich.solomayer@med.uni-tuebingen.de
Diel
I J
IJ
Salanti
G
G
Hahn
M
M
Gollan
C
C
Schütz
F
F
Bastert
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology*; D001854:Bone Marrow Cells / Q000473:pathology*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D017273:Goserelin / Q000627:therapeutic use; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016196:S Phase; D015996:Survival Rate; D013629:Tamoxifen / Q000627:therapeutic use; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen; D017273:Goserelin