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01-04-2014 | Clinical trial

Disseminated tumor cells as a monitoring tool for adjuvant therapy in patients with primary breast cancer

Authors: Ines Gruber, Tanja Fehm, Florin Andrei Taran, Markus Wallwiener, Markus Hahn, Diethelm Wallwiener, Natalia Krawzyck, Juergen Hoffmann, Andreas Daniel Hartkopf

Published in: Breast Cancer Research and Treatment | Issue 2/2014

Abstract

The presence of disseminated tumor cells (DTC) in the bone marrow (BM) of early breast cancer patients at initial surgery as well as during follow-up predicts an unfavorable outcome. This study aimed to assess whether adjuvant systemic therapy has the ability to eradicate DTC and to determine the clinical impact of DTC-persistence. Between 12 and 24 months after an initial BM aspiration during primary surgery (BMA1) a second and third bone marrow aspiration (BMA2 and BMA3, respectively) was performed. DTC were identified by immunocytochemistry (pancytokeratin antibody A45-B/B3) and cytomorphology. A total of 190 patients who were DTC-positive at BMA1 were eligible for this retrospective analysis. DTC persisted in 35 of 190 (19 %) patients at BMA2 and in 11 of 71 (16 %) patients at BMA3. DTC-persistence at BMA3 was significantly lower in patients that received adjuvant endocrine therapy (p = 0.017). At BMA2, DTC-positive patients were at an increased risk of disease recurrence (HR: 4.17, 95 % CI: 1.51–11.50, p = 0.003) and death (HR: 5.02, 95 % CI: 1.156–21.83, p = 0.031). At BMA3, the presence of DTC was associated with shorter disease free survival (HR: 3.20, 95 % CI: 1.05–9.78, p = 0.010). In conclusion, a majority of initially DTC-positive primary breast cancer patients turned negative during adjuvant treatment. As DTC-persistence predicted an adverse outcome, serial DTC-determination can identify patients that will probably benefit from additional or a switch of adjuvant therapy.

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Title: Disseminated tumor cells as a monitoring tool for adjuvant therapy in patients with primary breast cancer
Authors: Ines Gruber
Tanja Fehm
Florin Andrei Taran
Markus Wallwiener
Markus Hahn
Diethelm Wallwiener
Natalia Krawzyck
Juergen Hoffmann
Andreas Daniel Hartkopf
Publication date: 01-04-2014
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2014
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-014-2853-6

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