Bone marrow micrometastases in breast cancer patients.

Overview

BACKGROUND: The status of the axillary nodes has historically been the most important indicator of prognosis in breast cancer patients. However, approximately one third of node-negative patients recur with systemic disease. The detection of bone marrow micrometastases (BMM) may represent additional information in predicting distant recurrence and survival. METHODS: Bone marrow aspiration is obtained from the patient's anterior iliac crest at the time of breast cancer surgery. Cytospins are prepared from this aspirate and stained for polymerase chain reaction (PCR) analysis. RESULTS: Multiple studies have evaluated the clinical implications of BMM. The majority of studies have found a significant correlation between the presence of BMM and decreased survival. The information of bone marrow status may serve as a complement to axillary lymph node status in assessing the prognosis of breast cancer patients. CONCLUSIONS: There is a strong correlation between the presence of bone marrow micrometastases and poorer survival. These results may have an impact upon therapeutic recommendations in breast cancer patients.