The detection of epithelial cells in the bone marrow (BM) of primary breast cancer
(BC) patients may be the missing link between the local disease and the development
of secondary metastases to bone or other sites (micrometastasis. The detection of
those cells was used in several studies to assess the prognosis of BC patients and
may define the therapeutic setting of new therapies.
In this study we compared 622 BC patients with (MUC-antibody used; group BM(+)) against
634 patients without detected epithelial cells in BM (group BM(-)) regarding their
prognosis. Patients were operated at the Dept. of gynecology of the University Clinics
of Heidelberg/ Germany between 1990 and 2000. Mean follow up time was 83±39 months.
Primary clinical and pathological stage of disease was similar in both groups.
22.4% of the patients with micrometastases developed bone metastases in comparison
to 13.6% of the patients without (to other sites 14.8% respective 7.3%). Overall survival
was significantly lower in the micrometastatic group (p<0.001). 15.3% of KM(+) in
comparison to 27.8% (KM(+)) died because of BC, 10 year survival rate was 81.1% in
comparison to 66.0%. The RR for death because of BC was 2.11 (95%KI: 1.64, 2.72) for
KM(+) patients. RR adjusted for tumor size, nodalstatus, and grading was 1.62 (1.25,
2.10).
Our analysis confirm the results of our earlier studies as well as those of other
groups but with the longest follow up time period ever published. The detection of
epithelial cells in the BM of BC patients is an independent prognostic factor and
should have an impact to the therapeutical setting.
