Effect of primary anthracycline-based chemotherapy on disseminated tumor cells in locally advanced breast cancer.
BACKGROUND
The leading cause of death from epithelial cancer is metastatic tumor relapse due to early dissemination of tumor cells. In this study we investigated the elimination rate of disseminated tumor cells in bone marrow and the clinical response under primary chemotherapy in locally advanced breast cancer.


METHODS
Thirty patients underwent primary anthracycline-containing chemotherapy for breast cancer. For immunocytochemical tumor cell detection in bone marrow, the monoclonal antibody 5D3 was used.


RESULTS
At time of diagnosis, 10/30 (33%) patients had cytokeratin-positive tumor cells in bone marrow. After primary and chemotherapy, 8/30 (27%) patients still tested positive. Clinical complete response (cCR) was observed in 5/30 (17%) patients partial response (cPR) in 12/30 (40%) patients, resulting in an overall rate of clinical response to primary chemotherapy in 57%.


CONCLUSIONS
Primary chemotherapy in breast cancer is effective regarding the reduction of tumor size but seems incapable of reducing the burden of disseminated tumor cells in bone marrow.
Jäger
Christoph
C
Department of Obstetrics and Gynecology, University of Ulm, Prittwitzstrasse 43, D-89075 Ulm, Germany. christoph.jaeger@medizin.uni-ulm.de
Kafka
Ariane
A
Bossert
Sandra
S
Grundmann
Regina
R
Windisch
Jasmin
J
Kreienberg
Rolf
R
Heilmann
Volker
V
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D017273:Goserelin / Q000008:administration & dosage; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000096:biosynthesis; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage; D010865:Pilot Projects; D013629:Tamoxifen / Q000008:administration & dosage; D043823:Taxoids / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine
D043823:Taxoids; D013629:Tamoxifen; D017273:Goserelin; D000077143:Docetaxel; D015251:Epirubicin; D014747:Vinblastine; D007633:Keratins; D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel; D000077235:Vinorelbine; D008727:Methotrexate