Cytokeratin-positive cells in the bone marrow and survival of patients with stage I, II, or III breast cancer
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Summary
This summary is machine-generated.The presence of cytokeratin-positive micrometastases in bone marrow significantly increases the risk of distant metastasis and death in women with breast cancer. This finding highlights bone marrow micrometastases as a critical prognostic indicator for breast cancer patients.
Area Of Science
- Oncology
- Cancer Metastasis Research
- Diagnostic Biomarkers
Background
- Cytokeratins are established biomarkers for epithelial cancer cells.
- Their presence in bone marrow indicates occult micrometastases.
- Assessing these micrometastases is crucial for breast cancer prognosis.
Purpose Of The Study
- To evaluate the prognostic impact of cytokeratin-positive micrometastases in bone marrow.
- To determine the association between bone marrow micrometastases and breast cancer outcomes.
- To identify independent prognostic indicators for breast cancer relapse.
Main Methods
- Bone marrow aspirates collected from 552 stage I-III breast cancer patients and 191 non-malignant controls.
- Immunohistochemical staining using monoclonal antibody A45-B/B3 to detect cytokeratin-positive cells.
- Median follow-up of 38 months, with survival as the primary endpoint.
Main Results
- Cytokeratin-positive cells detected in 36% of breast cancer patients versus 1% of controls.
- Bone marrow micrometastases were independent predictors of distant metastasis and cancer-related death (P<0.001).
- Presence of micrometastases increased the risk of death by over fourfold (RR, 4.17).
Conclusions
- Occult cytokeratin-positive cells in bone marrow are a significant prognostic factor.
- These micrometastases increase the risk of relapse and cancer-related mortality in breast cancer patients.
- Bone marrow examination can refine prognostication for early-stage breast cancer.