ERalpha-status of disseminated tumour cells in bone marrow of primary breast cancer patients
Open Access
- 15 September 2008
- journal article
- Published by Springer Science and Business Media LLC in Breast Cancer Research
- Vol. 10 (5), R76
- https://doi.org/10.1186/bcr2143
Abstract
Isolated disseminated tumour cells (DTC) are regarded as surrogate markers for minimal residual disease in breast cancer. Characterisation of these cells could help understand the known limitations of adjuvant therapy. Of particular interest is their oestrogen-receptor (ER) status because endocrine adjuvant therapy remains a cornerstone of breast cancer treatment. Bone marrow (BM) aspirates from 254 patients with primary breast cancer were included in this study. A double immunofluorescence staining procedure was established for the identification of cytokeratin (CK) positive/Erα-positive cells. ERα status of the primary tumour was assessed immunohistochemically using the same antibody against ERα. In 107 of 254 (42%) breast cancer patients, CK-positive cells could be detected in the BM. More than one DTC in the BM was observed in 38 of the 107 patients. The number of detected cells ranged between 1 and 55 cells per 2 × 106 mononuclear cells. DTCs demonstrated ERα positivity in 12% of the patients. The ERα expression was heterogeneous in 10 of the 38 (26%) patients with more than one DTC. The concordance rate of ERα status between primary tumour and DTC was 28%. Only 12 of 88 patients with ERα-positive tumours also had ERα-positive DTCs. Primary tumours and DTCs displayed a concordant ERα status in only 28% of cases. Most of the DTCs were ERα negative despite the presence of an ERα-positive primary tumour. These findings further underline the distinct nature of DTCs and may explain the failure rates seen in conventional endocrine adjuvant therapy.Keywords
This publication has 40 references indexed in Scilit:
- Random mutations, selected mutations: A PIN opens the door to new genetic landscapesProceedings of the National Academy of Sciences of the United States of America, 2006
- uPAR and HER-2 gene status in individual breast cancer cells from blood and tissuesProceedings of the National Academy of Sciences of the United States of America, 2006
- A concept for the standardized detection of disseminated tumor cells in bone marrow from patients with primary breast cancer and its clinical implementationCancer, 2006
- Comparison of HER2 status between primary tumor and disseminated tumor cells in␣primary breast cancer patientsBreast Cancer Research and Treatment, 2006
- Detection of cytokeratin-positive cells in the bone marrow of breast cancer patients undergoing adjuvant therapyBreast Cancer Research and Treatment, 2005
- A Pooled Analysis of Bone Marrow Micrometastasis in Breast CancerNew England Journal of Medicine, 2005
- Prospective identification of tumorigenic breast cancer cellsProceedings of the National Academy of Sciences of the United States of America, 2003
- Genetic heterogeneity of single disseminated tumour cells in minimal residual cancerThe Lancet, 2002
- Cytokeratin-Positive Cells in the Bone Marrow and Survival of Patients with Stage I, II, or III Breast CancerNew England Journal of Medicine, 2000
- Micrometastatic Breast Cancer Cells in Bone Marrow at Primary Surgery: Prognostic Value in Comparison With Nodal StatusJNCI Journal of the National Cancer Institute, 1996