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Micrometastases often persist in breast cancer patients
Reuters Health
Posting Date: March 8, 2005
Last Updated: 2005-03-08 11:27:01 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Despite undergoing surgery and receiving adjuvant therapy, most patients with early-stage breast cancer have bone marrow micrometastases up to 4 years later, according to a report in the March 10th issue of the International Journal of Cancer.
Dr. Martin J. Slade, from Imperial College London, and colleagues used a quantitative PCR (QPCR) technique they developed to look for transcripts of cytokeratin 19, a cancer marker, in the blood and bone marrow of 131 women with breast cancer, most of whom had node-negative T1 disease. These results were compared with standard immunohistochemistry findings.
All of the patients were treated with surgery and adjuvant therapy and had no evidence of metastatic disease on conventional scans.
About half of the patients had QPCR or immunohistochemistry results that indicated bone marrow micrometastases before surgery, the authors note. Of the 91 subjects who had repeat samples taken, 87% and 65% had evidence of metastatic disease at some point with QPCR and immunohistochemistry, respectively.
Systemic adjuvant therapy seemed to have an effect on residual disease. Among patients with residual disease before treatment or at 3 months, 32 of 44 displayed a drop in the CK19/ABL ratio and 15 of 24 showed a drop in cytokeratin-positive cells during follow-up, the authors point out.
"We have demonstrated that in a substantial proportion of patients, minimal residual disease persists using the techniques that we have developed, and that it is possible to monitor patients, preferably using both QPCR and immunohistochemistry, after breast surgery using bone marrow aspirates," the researchers conclude.
Int J Cancer 2005;114:94-100.
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