title: Bone marrow micrometastases in early breast cancer-30-year outcome.
abstract: BACKGROUND
  Micrometastases in bone marrow of women with early breast cancer were first identified immunocytochemically in the 1980s. We report on the original cohort of women with a median follow-up of 30 years.
  
  
  METHODS
  In total, 350 women with primary breast cancer had eight bone marrow aspirates examined with antibody to epithelial membrane antigen. Data on long-term mortality were obtained via record linkage to death certification.
  
  
  RESULTS
  At a 30-year median follow-up, 79 out of 89 (89%) patients with micrometastases have died compared with 202 out of 261 (77%) without (hazard ratio=1.46 (95% CI 1.12-1.90), P=0.0043). Most marked effect of micrometastases on overall survival (OS) was seen in patients aged ⩽ 50 at surgery (N=97, P=0.012), and on all patients within 10 years of diagnosis. In multivariable analyses, the presence of micrometastases was no longer a statistically significant prognostic factor.
  
  
  CONCLUSIONS
  Bone marrow micrometastases are predictive for OS, particularly in the first decade and in younger patients.
authors.affiliation: Department of Oncology, Guy's and St Thomas' NHS Foundation Trust and Biomedical Research Centre, King's College London, London, SE1 9RT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Mansi
authors.affiliation: ICR Clinical Trials & Statistics Unit (ICR-CTSU), Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK.
authors.forename: J
authors.initials: J
authors.lastname: Morden
authors.affiliation: ICR Clinical Trials & Statistics Unit (ICR-CTSU), Division of Clinical Studies, The Institute of Cancer Research, London, SM2 5NG, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Bliss
authors.affiliation: Ludwig Institute for Cancer Research, New York, NY 10158, USA.
authors.forename: M
authors.initials: M
authors.lastname: Neville
authors.affiliation: Division of Cancer, Imperial College London, London, W12 0NN, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Coombes
mesh_terms: D000368:Aged; D019046:Bone Marrow Neoplasms / Q000378:metabolism / Q000556:secondary* / Q000628:therapy; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D061206:Neoplasm Micrometastasis; D011379:Prognosis; D016016:Proportional Hazards Models; D047368:Tumor Burden
chemical_list: D018396:Mucin-1