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Bone marrow micrometastases in 109 breast cancer patients: Correlations with clinical and pathological features and prognosis

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Abstract

Background: The presence in bone marrow of cells which react with monoclonal antibodies against tumor-associated antigens has been proposed over the last few years as a new prognostic factor in breast cancer patients. Patients and methods: Bone marrow aspirates were obtained from 109 stage I and II breast cancer patients during or 2–4 weeks after primary surgery. The samples were processed for leukocyte separation on a Ficoll-Hypaque gradient and then used to prepare cytospin slides for immunocytochemical analysis. The slides were stained with a pool of monoclonal antibodies (MoAbs) which recognize tumor associated antigens, using the alkaline phosphatase anti-alkaline phosphatase method. The median follow-up was 36 months (range 15–62); 22 patients relapsed and 7 died. Results: Thirty-four of the 109 patients (31.1%) had MoAb positive bone marrow cells. The bone marrow was positive in 28/74 (37.9%) patients who had the aspirate taken during surgery and in 6/35 (17.1%) who had it taken after surgery (p = 0.055). No association was found between bone marrow positivity and tumour size, nodal status, menopausal status, estrogen receptor positivity or the proliferative index. No association was found between bone marrow and prognosis: the log-rank test was 0.291 (p > 0.5) for OS and 0.023 for DFS; the hazard ratio (positive vs negative) was 1.51 for OS (95% CI: 0.33–6.86) and 0.93 for DFS (95% CI: 0.35–2.45). Conclusions: In our series, bone marrow positivity did not correlate with prognostic parameters or prognosis. Of interest is the relative excess of positivity when the bone marrow was obtained during surgery.

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Authors and Affiliations

  1. Departments of Medical Oncology, University of Verona, Italy

    Annamaria Molino, Monica Turazza, Loris Sperotto, Andrea Bonetti, Rolando Nortilli, Flavia Pavanel & Gian Luigi Cetto

  2. Pathology, Azienda Ospedaliera, Verona

    Giuseppe Pelosi & Quirino Piubello

  3. Surgery, Azienda Ospedaliera, Verona

    Giovanni Fattovich & Cristoforo Alaimo

  4. Institute of Statistics, University of Trento, Italy

    Rocco Micciolo

Authors
  1. Annamaria Molino
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  2. Giuseppe Pelosi
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  3. Monica Turazza
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  4. Loris Sperotto
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  5. Andrea Bonetti
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  6. Rolando Nortilli
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  9. Quirino Piubello
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  10. Flavia Pavanel
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  11. Rocco Micciolo
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  12. Gian Luigi Cetto
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Molino, A., Pelosi, G., Turazza, M. et al. Bone marrow micrometastases in 109 breast cancer patients: Correlations with clinical and pathological features and prognosis. Breast Cancer Res Treat 42, 23–30 (1997). https://doi.org/10.1023/A:1005747711084

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