title: Disseminated tumor cells in the bone marrow of patients with ductal carcinoma in situ.
abstract: Detection of disseminated tumor cells (DTCs) in bone marrow is an independent prognostic factor in primary breast cancer. Here, we conducted a proof-of-principle study to evaluate whether this tumor cell spread occurs already in patients with ductal carcinoma in situ (DCIS). After preoperative screening by stereotactic core biopsy, 30 consecutive women with DCIS were included. Bone marrow aspirates, taken at the time of primary surgery, were subjected to DTC detection by a standardized immunoassay using the established monoclonal anti-cytokeratin antibodies A45-B/B3 and AE1/AE3. DTCs were detected in 4 of 19 cases of pure DCIS (21.1%) and in four of seven cases of DCIS with microinvasion (57.1%). After a median follow-up time of 22 months, two initially DTC-positive patients suffered from contralateral carcinoma and contralateral DCIS at months 12 and 30, respectively, whereas the remaining patients were relapse free. Thus, hematogenous tumor cell dissemination into bone marrow is an early event in breast cancer development.
authors.affiliation: Department of Gynaecology and Obstetrics, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sänger
authors.forename: Katharina E
authors.initials: KE
authors.lastname: Effenberger
authors.forename: Sabine
authors.initials: S
authors.lastname: Riethdorf
authors.forename: Viviane
authors.initials: V
authors.lastname: Van Haasteren
authors.forename: Johannes
authors.initials: J
authors.lastname: Gauwerky
authors.forename: Inka
authors.initials: I
authors.lastname: Wiegratz
authors.forename: Klaus
authors.initials: K
authors.lastname: Strebhardt
authors.forename: Manfred
authors.initials: M
authors.lastname: Kaufmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Pantel
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis