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Detection of disseminated tumor cells from the bone marrow of patients with early breast cancer is associated with high 21-gene recurrence score

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Abstract

High 21-gene recurrence score (RS) is associated with an impaired prognosis in patients with HR-positive/HER2-negative early breast cancer (EBC) and predictive of response to adjuvant chemotherapy. Detection of disseminated tumor cells (DTCs) in the bone marrow is a surrogate of minimal residual disease and of prognostic value. The aim of this study was to compare DTC detection with the 21-gene RS. DTCs were identified in bone marrow aspirates of HR-positive/HER2-negative EBC patients by immunocytochemistry (pancytokeratin antibody A45-B/B3) and cytomorphology at primary surgery. The 21-gene RS was assessed in paraffin-embedded tumor tissue samples using Oncotype DX (Genomic Health). A total of 114 patients were included in this study. DTCs were detected in 13 of these (11 %). Of the women with a low RS (<18), 5/75 (7 %) were DTC positive. Of the women with an intermediate/high RS (≥18), 8/39 (21 %) were DTC positive (p = 0.03, Chi-squared test). The median RS in DTC-negative patients was significantly lower as compared to DTC-positive patients (15 vs. 20, p = 0.04, Mann–Whitney U test). In conclusion, detection of DTCs in patients with EBC is associated with high 21-gene recurrence score. These findings are meaningful for further basic research that aims to investigate the biological mechanism of tumor cell spread and cancer progression and may have prognostic and/or predictive clinical implications that should be evaluated in future clinical trials.

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Funding

A. D. Hartkopf has received the financial support for attending symposia from Genomic Health Inc. (Redwood City, CA, USA).

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    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany

      Andreas D. Hartkopf, Stefan Kommoss, Florin-Andrei Taran & Sara Y. Brucker

    2. Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

      Markus Wallwiener

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    1. Andreas D. Hartkopf
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    2. Markus Wallwiener
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    4. Florin-Andrei Taran
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    5. Sara Y. Brucker
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    Correspondence to Andreas D. Hartkopf.

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    The other authors (MW, SK, FAT, SYB) declare that they have no conflict of interest.

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    Florin-Andrei Taran and Sara Y. Brucker have equally contributed to this work.

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    Hartkopf, A.D., Wallwiener, M., Kommoss, S. et al. Detection of disseminated tumor cells from the bone marrow of patients with early breast cancer is associated with high 21-gene recurrence score. Breast Cancer Res Treat 156, 91–95 (2016). https://doi.org/10.1007/s10549-016-3728-9

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    • DOI: https://doi.org/10.1007/s10549-016-3728-9

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