Detection of disseminated tumor cells in bone marrow predict late recurrences in operable breast cancer patients | BMC Cancer | Full Text

Detection of disseminated tumor cells in bone marrow predict late recurrences in operable breast cancer patients | BMC Cancer | Full Text

BMC Cancer

Detection of disseminated tumor cells in bone marrow predict late recurrences in operable breast cancer patients

• Kjersti Tjensvoll, 
• Oddmund Nordgård, 
• Maren Skjæveland, 
• Satu Oltedal, 
• Emiel A. M. Janssen & 
• Bjørnar Gilje 

BMC Cancer volume 19, Article number: 1131 (2019) Cite this article

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Abstract

Background

Operable breast cancer patients may experience late recurrences because of reactivation of dormant tumor cells within the bone marrow (BM). Identification of patients who would benefit from extended therapy is therefore needed.

Methods

BM samples obtained pre- and post-surgery were previously analysed for presence of disseminated tumor cells (DTC) by a multimarker mRNA quantitative reverse-transcription PCR assay. Updated survival analyses were performed on all patient data (n = 191) and in a subgroup of patients alive and recurrence-free after 5 years (n = 156). DTC data were compared to the mitotic activity index (MAI) of the primary tumors. Median follow-up time was 15.3 years.

Results

Among the 191 patients, 49 (25.65%) experienced systemic relapse, 24 (49%) within 5–18 years after surgery. MAI and pre- and post-operative DTC status had significant prognostic value based on Kaplan–Meier analyses and multiple Cox regression in the overall patient cohort. With exclusion of patients who relapsed or died within 5 years from surgery, only pre-operative DTC detection was an independent prognostic marker of late recurrences. High MAI (≥10) did not predict late recurrences or disease-specific mortality.

Conclusion

Pre-operative DTC detection, but not MAI status, predicts late recurrences in operable breast cancer.