title: Impaired bone microenvironment: correlation between bone density and presence of disseminated tumor cells.
abstract: BACKGROUND
  Disseminated tumor cells (DTCs) in bone marrow (BM) occur in 30-40% of primary breast cancer patients. An impaired bone microenvironment may lead to reduced bone density and osteoporosis affecting the BM as a homing site for DTCs. The bone mineral density (BMD) and its correlation to DTC in BM was evaluated.
  
  
  METHODS
  One hundred and eighty-one women (70 premenopausal, 111 postmenopausal) underwent quantitative ultrasonometry before adjuvant chemotherapy. BM aspirates were analyzed by immunocytochemistry using the ACIS system (Chromavision) based on immunostaining.
  
  
  RESULTS
  DTCs were detected in 39% of the patients. Positive BM status correlated significantly with the nodal status. BMD was significantly reduced in the postmenopausal patients (p=0.003). Smaller tumors and higher BMD correlated significantly (p<0.014). Fifty percent of the patients with preclinical osteoporosis were BM positive, whereas 37% with normal or osteopenic BMD had DTCs.
  
  
  CONCLUSIONS
  An impaired bone micro-environment as found in preclinical osteoporosis might be a homing site for DTCs.
authors.affiliation: Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, 72076 Tuebingen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kraemer
authors.forename: R
authors.initials: R
authors.lastname: Rothmund
authors.forename: M
authors.initials: M
authors.lastname: Banys
authors.forename: N
authors.initials: N
authors.lastname: Krawczyk
authors.forename: E-F
authors.initials: EF
authors.lastname: Solomayer
authors.forename: C
authors.initials: C
authors.lastname: Mack
authors.forename: D
authors.initials: D
authors.lastname: Wallwiener
authors.forename: T
authors.initials: T
authors.lastname: Fehm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001853:Bone Marrow / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D016130:Immunophenotyping; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010024:Osteoporosis / Q000209:etiology; D017698:Postmenopause; D017697:Premenopause