Hematologic Findings in Cases of Mammary Cancer Metastatic to Bone Marrow

Abstract

The hematologic findings in 22 cases of mammary cancer metastatic to bone marrow are presented. Cancer of the breast was the most frequent neoplasm metastatic in bone marrow in this study of 2,878 bone-marrow examinations. All 22 patients who had carcinoma of the breast metastatic to bone marrow had clinical, radiographic, or hematologic evidence of widespread metastatic disease. Peripheral blood was abnormal in 58% of the cases, and in most of these cases two or more abnormalities were present. Bone-marrow biopsies were superior to particle sections and aspirates in identifying tumor, but correlations among all modalities were necessary for proper interpretation. Although the morphologic features of tumor cells in sections and smears were quite characteristic for carcinoma of the breast, pitfalls in interpretation were numerous and should be recognized. The mean survival time of these patients was only 6.9 months after identification of bone-marrow metastases. The significant response to chemotherapy obtained with some individuals, however, should encourage aggressive therapy of this disorder.

Increased detection of mammary carcinoma cells in marrow smears using antisera to epithelial membrane antigen

“…This has not been proved conclusively but considerable evidence from previous work has shown that EMA is only expressed by cells of epithelial or mesothelial derivation (Heyderman et al, 1979;Sloane & Ormerod, 1981). In the present study it was found that: (1) (Riddell & Landys, 1979;Leland & Macpherson, 1979;Ingle et al, 1978;Coombes et al, 1980). The increased diagnostic yield using trephine biopsy together with marrow aspirates has been stressed (Ingle et al, 1978;Contreras et al, 1972;Bearden et al, 1974;Leland & Macpherson, 1979;Jamshidi & Swaim, 1971;Ellis et al, 1964) but as this is at least in part due to difficulty in aspirating carcinoma cells from scirrhous tumour masses (Leland & Macpherson, 1979) it may be of less importance when attempting to detect truly micrometastatic infiltration.…”

“…In the present study it was found that: (1) (Riddell & Landys, 1979;Leland & Macpherson, 1979;Ingle et al, 1978;Coombes et al, 1980). The increased diagnostic yield using trephine biopsy together with marrow aspirates has been stressed (Ingle et al, 1978;Contreras et al, 1972;Bearden et al, 1974;Leland & Macpherson, 1979;Jamshidi & Swaim, 1971;Ellis et al, 1964) but as this is at least in part due to difficulty in aspirating carcinoma cells from scirrhous tumour masses (Leland & Macpherson, 1979) it may be of less importance when attempting to detect truly micrometastatic infiltration. Our series of marrow aspirates revealed positive or suspicious cells in 19/44 (430o) of metastatic patients, but also in 3/30 (10%) of patients without conventionally demonstrable metastases at any site, including 2/20 (10%) who had primary breast carcinomas with involved axillary nodes.…”

Untitled

“…Of the 37 positive cases, 6 (16.2%) had leukoerythroblastic picture with immature granulocytes and nucleated red cells in the peripheral smear. Similarly, Contreras et al [6] found leukoerythroblastic picture in 22% of their cases and Leland and MacPherson [7] in 33% of their cases. In our study, nucleated red cell and immature granulocytes were seen when the hemoglobin was reduced below 7.0% gm.…”

Non-haematopoietic malignancies metastasing to the bone marrow: A 5 year record-based descriptive study from a tertiary care centre in South India

“…Contreras et al [6] found leucoerythroblastic reaction in 22% of their cases and Leland and McPherson [7] in 33% of their cases. In our study, nucleated red cell and immature granulocytes were not seen in patients in whom the haemoglobin was 10% gm.…”