title: Intraoperative bone marrow puncture in breast cancer patients: prospective assessment of adverse side-effects.
abstract: OBJECTIVE
  In breast cancer patients, intraoperative bone marrow puncture (BMP) with positive detection of disseminated tumor cells has been reported to predict unfavorable clinical outcome due to increased risk of recurrence. In this study, we prospectively assessed BMP-associated untoward side-effects.
  
  
  METHODS
  Fifty-eight consecutive breast cancer patients were prospectively explored after intraoperative BMP for postoperative pain (visual analogue scale, VAS) and complications in terms of infection, hematoma, and sensibility disorder. Furthermore, the impact of BMP on hospital stay duration was analyzed in 254 patients.
  
  
  RESULTS
  In all subgroups analyzed, during five postoperative days patients complained about minor pain only at the site of BMP (VAS < 1) while the corresponding pain scores were significantly higher for the area of the operated breast. Post-BMP iliac crest hematomas were encountered in 13 out of 58 patients (22.4%) who were significantly older (p = 0.04), less frequently smokers (p = 0.02), and presented with higher body mass index (p = 0.01) than controls. Within the area of BMP no signs of infection or sensibility disorders were observed. Comparison of patients with and without BMP did not show any significant difference in postoperative hospital stay duration.
  
  
  CONCLUSIONS
  Referring to the potential clinical benefit of intraoperative BMP its prospectively assessed adverse side-effects appear relatively mild and thus acceptable.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Vossstrasse 9, Heidelberg, Germany. christoph.domschke@med.uni-heidelberg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Domschke
authors.forename: Florian
authors.initials: F
authors.lastname: Neubrech
authors.forename: Michelle
authors.initials: M
authors.lastname: Dick
authors.forename: Joachim
authors.initials: J
authors.lastname: Rom
authors.forename: Philipp
authors.initials: P
authors.lastname: Beckhove
authors.forename: Christof
authors.initials: C
authors.lastname: Sohn
authors.forename: Florian
authors.initials: F
authors.lastname: Schuetz
authors.forename: Alexander
authors.initials: A
authors.lastname: Scharf
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology* / Q000601:surgery*; D001856:Bone Marrow Examination / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects; D015411:Mastectomy, Modified Radical / Q000009:adverse effects; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects