Detection of Occult Metastases in the Bone Marrow in Patients with Early Stage Breast Cancer Clinical Significance

OMBM have been correlated with known predictors of prognosis in several studies. In our studies (14), the lymph node-negative group had fewer extrinsic cells than the lymph node-positive group, suggesting a trend toward a greater metastatic tumor burden in patients with lymph node metastases.

The presence of OMBM has been correlated with pathologic Tumor-Node-Metastasis (TNM) stage in breast cancer. Several other investigators have obtained similar results. In the original study from the Ludwig Institute (11), the presence of OMBM was correlated with the tumor stage (p = 0.05), and vascular invasion (p < 0.01), both of which are known predictors of poor prognosis.

While the presence of OMBM appears to be correlated with known features of disease progression, the ultimate utility of this test will be determined by whether it can predict breast cancer recurrence. Several studies now show that, in fact, the presence of occult metastases in the bone marrow identifies a population of patients at high risk for recurrence (Table 1) (14,71-76). Our own studies (14) have revealed that the presence of occult metastases in the bone marrow significantly predicts recurrence; the 2-yr recurrence rate for patients with no evidence of OMBM was 3% compared with 33% for patients with detectable OMBM. Diel and associates (71) studied 727 patients with primary operable breast cancer. They were able to detect tumor cells in the bone marrow of 55% of lymph node-positive

Table 1

Detection of Occult Bone Marrow Metastases in Breast Cancer

Table 1

Detection of Occult Bone Marrow Metastases in Breast Cancer

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