Epithelial Cells in Bone Marrow of Breast Cancer Patients at Time of Primary Surgery: Clinical Outcome During Long-Term Follow-Up

Gebauer, Gerhard; Fehm, Tanja; Merkle, E.; Beck, Eberhard; Lang, N.; Jäger, Wolfram

doi:10.1200/jco.2001.19.16.3669

Cited by 180 publications

(124 citation statements)

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“…In the present work, we observed an increase in both sensitivity (89%) and negative predictive value (84%), which has to be related to the additional use of ICC. The use of a cocktail of antiepithelial membrane antigen and antipancytokeratin antibodies for identify-ing scattered epithelial cancer cells has been proposed recently in bone marrow smears (Gebauer et al, 2001). The possibility of using the same smears obtained for routine H&E staining for additional ICC analyses with the cocktail of antibodies recognising different antigens is an interesting approach, which reduces further sampling of the LN, and limits potential diagnostic pitfalls.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

et al. 2003

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The knowledge of the status of axillary lymph nodes (LN) of patients with breast cancer is a fundamental prerequisite in the therapeutic decision. In the present work, we evaluated the impact of fine-needle aspiration cytology (FNAC) of ultrasonographically (US) selected axillary LN in the diagnosis of LN metastases and subsequently in the treatment of patients with breast cancer. Axillary US was performed in 298 patients with diagnosed breast cancer (267 invasive carcinomas and 31 ductal carcinoma in situ DCIS), and in 95 patients it was followed by FNAC of US suspicious LN. Smears were examined by routine cytological staining. Cases of uncertain diagnosis were stained in immunocytochemistry (ICC) with a combination of anticytokeratin and anti-HMFG2 antibodies. Eighty-five FNAC were informative (49 LN were positive for metastases, 36 were negative). In 49 of 267 patients with invasive breast carcinoma (18%), a preoperative diagnosis of metastatic LN in the axilla could be confirmed. These patients could proceed directly to axillary dissection. In addition, US-guided FNAC presurgically scored 49 out of 88 (55%) metastatic LN. Of all others, with nonsuspicious LN on US (203 cases including 31 DCIS), in which no FNAC examination was performed, 28 invasive carcinomas (16%) turned out to be LN positive on histological examination. Based on these data, US examination should be performed in all patients with breast cancer adding ICC-supported FNAC only on US-suspect LN. This presurgical protocol is reliable for screening patients with LN metastases that should proceed directly to axillary dissection or adjuvant chemotherapy, thus avoiding sentinel lymph node biopsy.

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Section: Discussionmentioning

confidence: 99%

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

et al. 2003

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“…8,10,[13][14][15][23][24][25] No significant differences in the detection rate of DTCs from the anterior and the posterior iliac crests have been reported. 26 Repeated bone marrow aspiration performed under local anesthesia also can be performed to obtain information regarding the persistence of DTCs.…”

Section: Methodological Aspects Of Bone Marrow Processing Collection mentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] DTCs can be detected in approximately 33% of breast cancer patients without any clinical evidence of metastatic disease (i.e., Stage I-III disease). The presence of DTCs also is described by synonyms, such as bone marrow micrometastasis or minimal residual disease, but the term DTCs is the most precise.…”

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A concept for the standardized detection of disseminated tumor cells in bone marrow from patients with primary breast cancer and its clinical implementation

Fehm

Braun

Müller

et al. 2006

Cancer

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Numerous single-institutional studies and a large pooled analysis have demonstrated that the presence of disseminated tumor cells (DTCs) in the bone marrow (BM) from patients with primary, nonmetastatic breast cancer (Stages I-III) is associated with impaired prognosis. To date, sampling of BM and assessment of DTCs is not considered a routine procedure in the clinical management of breast cancer patients; however, emerging data suggest a future role for risk stratification and monitoring of therapeutic efficacy. Because these clinical options need to be evaluated in trials to verify the principle of this concept in the clinical setting, agreement on the standardized detection of DTCs is necessary. Consequently, the German, Austrian, and Swiss Societies for Senology recently formed a panel 1) to review and discuss the existing methodologies, 2) to find a consen-

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“…В этой подгруппе не отмечено разницы в общей и без-рецидивной выживаемости в зависимости от наличия опухолевых клеток в КМ на момент установления ди-агноза. Важно отметить, что после 5-летнего наблю-дения 65 % пациенток с микрометастазами в КМ на момент постановки диагноза живы без признаков прогрессирования заболевания, т. е. диссеминация процесса в КМ в период первичного оперативного ле-чения не обязательно приводит к развитию отдален-ных метастазов [43]. .…”

Section: опухоли женской репродуктивной системы Tumors Of Female Reprunclassified

Treatment of patients with bone marrow metastases: the present state of the problem

Козловская¹,

Antonenkova²,

Zhavrid³

2016

Tumors of female reproductive system

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12М а м м о л о г и я / M a m m o l o g y 1 ' 2 0 1 6 Том 12 / Vol. 12 88.7 and 69.3 %, respectively (p < 0.01). ОПУХОЛИ ЖЕНСКОЙ РЕПРОДУКТИВНОЙ СИСТЕМЫ TUMORS OF FEMALE REPRODUCTIVE SYSTEM Key words: breast cancer, micrometastases, tumor cells in bone marrow, polymerase chain reactionРак молочной железы (РМЖ) представляет собой патогенетически полиморфное заболевание, поэтому все пациентки не могут получать одинаковое лечение с одинаковым эффектом. Несмотря на достигнутые результаты в ранней диагностике и успехи в комплекс-ной терапии (хирургическое лечение, послеопераци-онная лучевая и химиотерапия (ХТ)), безрецидивная выживаемость ограничена из-за возникновения отда-ленных метастазов, которые являются основной при-чиной смерти этой категории пациенток.По данным канцер-регистра Республики Беларусь, за 2014 г. зарегистрировано 3835 новых случаев РМЖ. Из этого числа 82,2 % заболеваний было выявлено на ранних стадиях опухолевого процесса. Лечение по радикальной программе получили 75,2 % женщин. Пятилетняя выживаемость пациенток с впервые уста-новленным диагнозом РМЖ в 2009 г. составила 76 %, среди женщин с I и II стадиями заболевания -85,6 %, с III стадией -58,6 %, с IV стадией -14,1 %. Смерт-ность от злокачественных новообразований молочной железы составила в 2014 г. 21 на 100 тыс. женщин [1].Таким образом, лечение первичного РМЖ является сложной и не окончательно решенной на сегодняшний день проблемой. На современном этапе план лечебных мероприятий включает, как правило, несколько компо-нентов: хирургическое лечение, лучевое лечение, ХТ, гормонотерапию в случае положительных гормональ-ных рецепторов в опухоли и таргетную терапию при экспрессии опухолью эпидермального фактора ро-ста 2-го типа (НЕR-2 / neu).Однако факторы, приводящие к развитию отда-ленных метастазов, до сих пор недостаточно изучены.

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Epithelial Cells in Bone Marrow of Breast Cancer Patients at Time of Primary Surgery: Clinical Outcome During Long-Term Follow-Up

Cited by 180 publications

References 20 publications

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast cancer management

A concept for the standardized detection of disseminated tumor cells in bone marrow from patients with primary breast cancer and its clinical implementation

Treatment of patients with bone marrow metastases: the present state of the problem

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