Micrometastases in Breast Cancer

Coombes, R. C.; Dearnaley, David P.; Redding, W H; Ormerod, M.G.; Skilton, R. A.; Sloane, J P; Imrie, S F; Edwards, Penelope; Monaghan, Paul; Neville, A. Munro

doi:10.1016/b978-0-08-030764-0.50072-0

Cited by 3 publications

(4 citation statements)

References 7 publications

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“…Another factor contributing to our detection rate might be the use of six aspiration sites (Coombes et al, 1983 (1991), it might be advisable for future studies of more patients to include this factor. The question of whether detected tumour cells are actually micrometastases or whether they are shed by the primary tumour or seeded during surgery without bearing any further clonogenic potential has been raised in the literature (Mansi et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

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Tumour cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up

Harbeck

Untch²,

Pache³

et al. 1994

Br J Cancer

203

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Section: Discussionmentioning

confidence: 99%

“…The skeletal system is the predominant relapse location in breast cancer (Coombes et al, 1983). It is therefore quite obvious to search there for early distant spread.…”

mentioning

confidence: 99%

Tumour cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up

Harbeck

Untch²,

Pache³

et al. 1994

Br J Cancer

203

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“…By using conventional haematological techniques the likelihood of isolating tumour cells in the bone marrow at the time of presentation is small,'45 but with the advent of immunocytochemistry the ability to detect not only small foci of tumour cells but also single cells has been greatly enhanced.267 Furthermore, by increasing the number ofmarrow sites examined a larger number of tumour cells can be detected. 2 Patients entered into this study had multiple bone marrow aspirates taken under general anaesthesia immediately preceding initial surgery and were followed up for a median of 28 months.…”

Section: Introductionmentioning

confidence: 99%

Micrometastases in bone marrow in patients with primary breast cancer: evaluation as an early predictor of bone metastases.

Mansi

Berger

Easton

et al. 1987

BMJ

183

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The bone marrow of 307 patients with primary breast cancer was examined for tumour cells by immunocytochemistry using an antiserum to epithelial membrane antigen. Micrometastases were found in 81 cases (26.4%) and their presence was related to various poor prognostic factors: spread to lymph nodes, vascular invasion, T stage, and pathological size. The median duration of follow up was 28 months. Seventy five patients relapsed, 60 at distant sites. Of these 60 patients, 26 had micrometastases detected at presentation and 34 were free of micrometastases initially. The relapse free interval was significantly shorter for patients with micrometastases, and these patients had a shorter survival. Analysis of the sites of relapse showed that the test

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“…Coombes was able to demonstrate clearly that the detection rate rises as the number of aspiration sites increases [15]. T his is confirmed by looking at the studies analyzed in this review (table 2): Groups that used only one aspiration site reported rather low detection rates [11.16].…”

Section: Number O F Aspiration Sites and Time O F Bone Marrow Aspirationmentioning

confidence: 60%

Clinical Relevance of Detection of Tumor Cells in the Bone Marrow of Primary Breast Cancer Patients: A Review

1997

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The prognostic relevance of tumor cell detection in the bone marrow of metastasis-free primary breast cancer patients has been controversial ever since the first publications by the London group of R.C. Coombes almost 15 years ago. Up till now, studies comprise data of more than 1,100 patients with median follow-up periods of 24-76 months. In about 35% of primary breast cancer patients and about 25% of node-negative patients, tumor cells can be detected immunocytochemically at the time of primary therapy. The various detection methods used differ mostly in regard to their choice of primary detection antibody. Most authors find a significant prognostic impact of tumor cell detection on relapse-free survival in both univariate and – in comparison to established prognostic factors – multivariate analysis. The little data available also indicate significant prognostic impact in multivariate analysis for overall survival. About 50% of all relapses were predicted by tumor cell detection at time of primary therapy. Only a few studies present follow-up results for the clinically important subgroup of node-negative patients. Regardless of their nodal status, tumor-cell-positive patients seem to have about twice the relapse rate of tumor-cell-negative patients. In conclusion, methodogical improvements are necessary before tumor cell detection in bone marrow can be routinely performed in primary breast cancer patients. In addition, large retrospective as well as prospective studies, especially for node-negative patients, are required, in order to decide whether tumor cell detection identifies a subgroup of high-risk patients that would have been missed by sole consideration of established prognostic factors. However, published follow-up data as well as recent results about the malignant phenotype of tumor cells detected in the bone marrow at time of primary therapy support the notion that some of these detected cells indeed possess metastatic potential.

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Micrometastases in Breast Cancer

Cited by 3 publications

References 7 publications

Tumour cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up

Tumour cell detection in the bone marrow of breast cancer patients at primary therapy: results of a 3-year median follow-up

Micrometastases in bone marrow in patients with primary breast cancer: evaluation as an early predictor of bone metastases.

Clinical Relevance of Detection of Tumor Cells in the Bone Marrow of Primary Breast Cancer Patients: A Review

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