The Relationship Between Micrometastases in the Bone Marrow, Histopathologic Features of the Primary Tumor in Breast Cancer and Prognosis

Abstract

The pathologic features of the primary tumors in 285 patients with breast cancer at the time of initial presentation, and with no clinical evidence of distant metastases, have been analyzed. The results have been compared with the detection of tumor cells in the bone marrow by use of an immunocytochemical method using antisera raised against the epithelial membrane antigen (EMA). The authors found EMA-positive cells (i.e., tumor cells) in the bone marrow of 77 (27%) patients and a significant association between the presence of such EMA-positive cells in the bone marrow and tumor size (P = 0.006) and peritumoral vascular invasion (P = less than 0.001). A possible relationship with estrogen receptor negativity (P = 0.06) also was noted.

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

“…Unspecific, false-positive staining has been reported with anti-EMA as well as anti-cytokeratin antibodies (Heyderman & McCartney, 1985;Ellis et al, 1989). This underlines the importance of using both immunocytochemical as well as morphological criteria before classifying cells as tumour cells (Berger et al, 1988). There are reports that anti-cytokeratin antibodies are less sensitive in recognising breast cancer metastases than anti-EMA (Thor et al, 1988).…”

Dynamic test with recombinant interferon-alpha-2b: effect on 90K and other tumour-associated antigens in cancer patients without evidence of disease

“…Cure rate in these patients is 50-60% (Berger et al, 1988); some of these patients have micrometastatic disease already at the time of the primary surgery (Berger et al, 1988;Fisher & Turnbull, 1955). Although in the absence of an adequate follow-up it is not possible to establish when the dynamic test has to be considered as 'true positive', i.e., leading to augmented antigen expression in those patients who will develop disease recurrence shortly after, two possibilities can be envisaged: either a shift from a negative (below the cut-off value) to a positive assay or a given increase of the antigen level irrespective of the basal value.…”

Clinical Significance of Occult Metastatic Cells in Bone Marrow of Breast Cancer Patients

“…Diel et al [6] found a significant correlation between bone marrow positivity and tumor size (p < 0.001), nodal status (p = 0.001), histopathologic tumor grading (p = 0.002), and postmenopausal status of the study patients (p = 0.01). The London Ludwig Cancer Institute Group described that the presence of EMA-positive cells in bone marrow was significantly related to lymph node involvement, peritumoral vascular invasion, and size of the primary tumor [27]. Studies using different anticytokeratin monoclonal antibodies demonstrated merely a tendency towards correlation between detection of cytokeratin-positive cells in bone marrow and locoregional lymph node involvement antibodies [3,20,28].…”