Article

Breast Cancer Research and Treatment

, Volume 97, Issue 1, pp 91-96

Detection of cytokeratin-positive cells in the bone marrow of breast cancer patients undergoing adjuvant therapy

  • Sven BeckerAffiliated withDepartment of Gynecology and Obstetrics, University Hospital Tübingen Email author 
  • , Graziella Becker-PergolaAffiliated withDepartment of Gynecology and Obstetrics, University Hospital Tübingen
  • , Diethelm WallwienerAffiliated withDepartment of Gynecology and Obstetrics, University Hospital Tübingen
  • , Erich-Franz SolomayerAffiliated withDepartment of Gynecology and Obstetrics, University Hospital Tübingen
  • , Tanja FehmAffiliated withDepartment of Gynecology and Obstetrics, University Hospital Tübingen

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Summary

The presence of cytokeratin-positive cells in the bone marrow of breast cancer patients has been proven to be an independent prognostic factor. Their fate in primary breast cancer patients undergoing adjuvant therapy is of particular interest. We investigated the bone marrow status of 112 patients undergoing postoperative adjuvant treatment before and after therapy. A total of 373 patients with histologically confirmed primary breast cancer underwent bone marrow aspiration at the time of primary surgery. All patients were informed of their bone marrow status and offered repeat aspiration after 12 months. All patients were then treated with adjuvant chemotherapy, endocrine therapy or both based on current treatment recommendations. About 112 patients returned for a second bone marrow aspiration after a mean interval of 12 months following the initiation of adjuvant treatment. In 93 of 112 patients (83%) disseminated tumor cells had been found in the bone marrow before initiation of systemic chemo/endocrine therapy. At the time of follow-up sampling, after surgery and completion of adjuvant chemotherapy, the positivity rate dropped to 24%. Positive bone marrow status during follow-up was only associated with grading (p=0.020). Adjuvant treatment regimens are not able to completely eliminate cytokeratin-positive cells from the bone marrow. Prospective studies need to evaluate, whether these cells could become targets for additional adjuvant therapy.

Keywords

adjuvant therapy bone marrow breast cancer disseminated tumor cells micrometastasis