HER2 Support Group Forums - View Single Post - her2 positivity changes everything--tumor cells can disseminate from earliest stages

Lani · 01-04-2008, 07:21 AM

here, why more bone marrow biopsies are not done to stage breast cancer patients and determine their risk of recurrence (particularly as part of clinical trials)

Here is an article from MD Anderson recommending further studies.

{I remember several years ago UCSF was going to include bone marrow samples taken at the time of initial surgery in some trial of theirs, but have never seen any results published.

The results published are mostly out of Germany from the group headed by Braun. They have published a great deal on this topic.}

Expert Rev Anticancer Ther. 2007 Oct;7(10):1463-72. Links
Significance of micrometastasis in bone marrow and blood of operable breast cancer patients: research tool or clinical application?

Lang JE, Hall CS, Singh B, Lucci A.
The University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, 1515 Holcombe Blvd, Houston, TX 77030, USA. jlang@surgery.arizona.edu
Approximately 25% of breast cancer patients without lymph node metastases develop systemic relapse. A growing body of data supports the notion that hematogenous dissemination of breast cancer cells occurs independently of lymphatic spread of disease; however, current clinical practice does not involve routine analysis of circulating or disseminated cells. Recent studies have documented that both circulating tumor cells (CTCs) within the blood and disseminated tumor cells (DTCs) in bone marrow can be identified using a variety of techniques. It is now clear that the presence of DTCs correlates with subsequent development of clinically evident bone metastases, and a worse outcome from breast cancer. While there are data identifying prognostic significance of CTCs in patients with metastatic breast cancer, there are few data regarding CTCs in operable patients. Factors such as presence of a cancer stem cell phenotype and/or certain microenvironmental conditions are involved in the establishment of distant metastases from a primary breast cancer, emphasizing the need for further studies within this area. The purpose of this report is to review the data regarding CTCs and DTCs in patients with operable breast cancer.
PMID: 17944570 [PubMed - indexed for MEDLINE]

Related Links
Detection and clinical implications of early systemic tumor cell dissemination in breast cancer.
[Clin Cancer Res. 2003]
Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comparison with nodal status.
[J Natl Cancer Inst. 1996]
Current status in human breast cancer micrometastasis.
[Curr Opin Oncol. 2007]
Clinical significance of immunocytochemical detection of tumor cells using digital microscopy in peripheral blood and bone marrow of breast cancer patients.
[Clin Cancer Res. 2004]
[Micrometastatic cells in the bone marrow of patients with breast carcinoma]
[Radiologe. 2000]

01-04-2008, 07:21 AM	#7
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	As you may recall I have been wondering "outloud" for years here, why more bone marrow biopsies are not done to stage breast cancer patients and determine their risk of recurrence (particularly as part of clinical trials) Here is an article from MD Anderson recommending further studies. {I remember several years ago UCSF was going to include bone marrow samples taken at the time of initial surgery in some trial of theirs, but have never seen any results published. The results published are mostly out of Germany from the group headed by Braun. They have published a great deal on this topic.} Expert Rev Anticancer Ther. 2007 Oct;7(10):1463-72. Links Significance of micrometastasis in bone marrow and blood of operable breast cancer patients: research tool or clinical application? Lang JE, Hall CS, Singh B, Lucci A. The University of Texas MD Anderson Cancer Center, Department of Surgical Oncology, Unit 444, 1515 Holcombe Blvd, Houston, TX 77030, USA. jlang@surgery.arizona.edu Approximately 25% of breast cancer patients without lymph node metastases develop systemic relapse. A growing body of data supports the notion that hematogenous dissemination of breast cancer cells occurs independently of lymphatic spread of disease; however, current clinical practice does not involve routine analysis of circulating or disseminated cells. Recent studies have documented that both circulating tumor cells (CTCs) within the blood and disseminated tumor cells (DTCs) in bone marrow can be identified using a variety of techniques. It is now clear that the presence of DTCs correlates with subsequent development of clinically evident bone metastases, and a worse outcome from breast cancer. While there are data identifying prognostic significance of CTCs in patients with metastatic breast cancer, there are few data regarding CTCs in operable patients. Factors such as presence of a cancer stem cell phenotype and/or certain microenvironmental conditions are involved in the establishment of distant metastases from a primary breast cancer, emphasizing the need for further studies within this area. The purpose of this report is to review the data regarding CTCs and DTCs in patients with operable breast cancer. PMID: 17944570 [PubMed - indexed for MEDLINE] Related Links Detection and clinical implications of early systemic tumor cell dissemination in breast cancer. [Clin Cancer Res. 2003] Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comparison with nodal status. [J Natl Cancer Inst. 1996] Current status in human breast cancer micrometastasis. [Curr Opin Oncol. 2007] Clinical significance of immunocytochemical detection of tumor cells using digital microscopy in peripheral blood and bone marrow of breast cancer patients. [Clin Cancer Res. 2004] [Micrometastatic cells in the bone marrow of patients with breast carcinoma] [Radiologe. 2000]