Detection of occult breast cancer cells by amplification of CK19 mRNA by reverse transcriptase-polymerase chain reaction: role of surgical manipulation.
BACKGROUND
To assess if surgical manipulation increases peripheral blood cancer cells dissemination in early stage (I and II) breast cancer patients.


METHODS
We analyzed 64 patients using RT-PCR for cytokeratin-19 as a marker for peripheral blood breast cancer cell dissemination. Peripheral blood was obtained at 4 different time-points (24 hours before and after surgery, one week and one month later).


RESULTS
RT-PCR was positive in 14 (24%) out of 59 evaluable patients. Circulating cells were detected in 4 out of 14 patients before surgery (7%) while in the remaining 10, the positivity was observed after surgery (17%). The percentage of patients with occult breast cancer cells increased significantly after surgery (p = 0.01).


CONCLUSIONS
1) 7% of early breast cancer patients had circulating tumor cells before surgery. 2) After surgery tumor cells were detected in 17% of patients. 3) Surgery significantly increased the presence of occult breast cancer cells. 4) The clinical significance of occult breast cancer cells should be tested within a larger clinical trial trying to assess their role as an independent prognostic factor.
Galán
Maica
M
Department of Medical Oncology, Institut Clínic de Malalties Hematològiques-Oncològiques (ICMHO), Hospital Clinic, University of Barcelona, Barcelona, Spain. mgalan@ico.scs.es
Viñolas
Nuria
N
Colomer
Dolors
D
Soler
Gemma
G
Muñoz
Montserrat
M
Longarón
Raquel
R
Ventura
Pere Joan
PJ
Gascón
Pere
P
Estapé
Jordi
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007633:Keratins / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism* / Q000473:pathology; D012333:RNA, Messenger / Q000097:blood* / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
D012333:RNA, Messenger; D007633:Keratins