Prognostic value of bone marrow biopsy in breast cancer

Abstract

Bone marrow biopsies (BMB) were performed on 622 women with a history of primary or metastatic breast cancer. In 332 of the patients bone scintigraphy (BSC) was also carried out at the time of initial diagnosis or during follow-up. The BMB revealed metastases in 22/88 patients (25%) in Stage I--III with positive BSC and in 39/111 patients (35%) in Stage IV with positive BSC, a total of 61/199 patients (31%). Moreover, the BMB was positive in 6/73 patients in Stage I--III with negative BSC, and in 5/37 patients in Stage IV with negative BSC, a total of 11/110 patients (10%). Statistical evaluation showed that the patients with BMB revealing tumor had a significantly higher death risk (P less than 0.0000001) than patients with BMB revealing tumor had a significantly higher death risk (P less than 0.0000001) than patients with negative BMB. No significant correlation was found in patients with positive or negative BSC. Similar results were also found for a subgroup of 207 patients who underwent BSC and BMB within five months. BMB may therefore be indicated for verification of metastases and prediction of prognosis in all patients with positive BSC and in BSC-negative patients Stage II--IV.

Recent advances in bone marrow scanning

“…Increasing evidence indicates that tumour cells seed to bone marrow early during cancer development (Hoover and Ketcham 1975;Ridell and Landys 1979;Meinshausen et al 1980;Landys 1982;Dearnaley et al 1983;Redding et al 1983;Levithan et al 1985;Soudah et al 1985;Mansi et al 1987Mansi et al , 1989Kamby et al 1987;Micheau et al 1987;Schlimok et al 1987;Berger et al 1988;Ceci et al 1988;Cote et al 1988). Bone marrow biopsies taken at the time of resection of the primary tumour (mostly carcinoma of the breast) disclosed in 10%~45% of patients single tumour cells (Redding et al 1983;Mansi et al 1987;Kamby et al 1987;Schlimok et al 1987;Cote et al 1988).…”

Metastasis of Solid Tumors in Bone Marrow: A Study from Northern India

“…Beside this the bone marrow examination is a commonly employed tool for staging and prognosis of various solid tumors [4,5].…”

Results of iliac crest biopsies taken from 1465 patients with primary breast cancer

“…The majority of these studies are retrospective surveys with small numbers of cases. As a result it may be said that no two studies were performed under the same conditions and it is, therefore, dicult to compare results (Ceci et al 1988;Cruiciani et al 1983;Di Stefano et al 1979;Ingle et al 1978;Landys 1982;Ridell and Landys 1979).…”

“…Results from earlier studies are controversial because dierent techniques were used to extract marrow and because selection criteria varied (Davies et al 1977;Diel et al 1992b;Shinozaki et al 1992;Landys and Stenram 1975). In contrast, bone biopsy is almost established in other ®elds such as hematology, endocrinology and osteology (Beckstead 1986;Burkhardt et al 1985;Landys 1982;Manegold et al 1986). …”