Department of Surgery, Chonnam National University Medical School, Kwangju, Korea.
ABSTRACT
PURPOSE: To determine accurately the extent of the disease and risk of recurrence is important in enhancing the therapeutic success rate of breast cancer. Primary tumor state and axillary node invasion were some well known factors to predict the prognosis of breast cancer. However, some patients with early stage cancer developed systemic metastasis later despite of little possibility of recurrence based on some previously establised prognostic system. These results demand another approach to predict systemic metastases in patient without gross evidence of further recurrence. Micrometastases is a promising key to explain the recurrence in these patients and micrometastases in bone marrow could raised the ongoing recurrence in skeletal system which is the most frequent metastatic site in breast cancer. Therefore we tricd to determine the rate of micrometastasis in surgically resectable Korean breast cancer patients and the relationship with clinicopathological characteristics of the cancer.
MATERIALS AND METHODS: We studied bone marrow aspirate specimens from 38 patients with breast cancer who underwent curative resection at Chonnam University Hospital from January 1996 to February 1997. And reverse transcription polymerase chain reaction (RT-PCR) to detect messenger RNA for cytokeratin 19 was performed.
RESULTS: Metastases in bone marrow were detected in 8/38 patients (21.1%). No sta- tistically significant relationship existed between bone marrow metastasis and clinicopa- thological parameters for predicting prognosis that consisted of tumor state, lymph node invasion, histologic grade, steroid receptor, and c-erbB2 overexpression. In particular, bone marrow metastasis developed even from ductal carcinoma in situ.
CONCLUSION: Bone marrow metastasis may be developed from the extremely early stage of breast cancer and we can not make the corelationship between the bone marrow metastasis and establised some prognostic factors. Based on these results, we recommand the evaluation of bone marrow metastasis in all breast cancer patients and require the close follow-up to allow more sensitive prediction of ongoing recurrence and higher curability.
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