According to a recent article published in Clinical Cancer Research, the presence of cancer cells in the bone marrow of breast cancer patients with no evidence of disease 3 years after diagnosis is indicative of shorter long-term survival.1
Breast cancer claims the lives of approximately 40,000 patients annually in the United States alone. Although patients whose breast cancer is detected and treated early (prior to spread to distant locations in the body) have high cure rates following standard therapy, some patients still experience a cancer relapse following a period of disease-free survival. Researchers are evaluating disease and/or patient variables that may place a patient at a high risk of developing a recurrence so that these patients may either undergo more intensive treatment than patients who are at a lower risk of a recurrence, or so that these patients may undergo frequent screening for recurrences so that treatment may begin as soon as a recurrence is detected.
Researchers from Norway recently conducted a clinical study to evaluate the association between the presence of cancer cells found in the bone marrow (spongy material inside large bones where blood cells are produced) and long-term prognosis in breast cancer patients. This trial included 356 patients who had been diagnosed with breast cancer and treated, and who were considered to be “disease-free” 3 years after their diagnosis. Over 70% of patients were node-negative, or did not have cancer spread to nearby lymph nodes. Patients had undergone a bone marrow examination for the presence of cancer cells at diagnosis and had undergone a second bone marrow test for the detection of isolated cancer cells. At 25 months following the second bone marrow test, patients with isolated cancer cells in their bone marrow had a recurrence rate of 21%, compared to only 7% in patients who did not have any cancer cells found in their bone marrow. Cancer cells in the bone marrow also predicted for a reduced survival from breast cancer. Upon evaluation of several different disease variables, the presence of isolated cancer cells in the bone marrow 3 years following diagnosis predicted for a worse overall long-term prognosis in patients compared to those with no cancer cells in their bone marrow. These results are consistent with previous clinical studies evaluating the presence of cancer cells in the bone marrow of breast cancer patients.2,3
The researchers concluded that the presence of isolated cancer cells in the bone marrow of patients diagnosed with breast cancer who were considered cancer-free 3 years following diagnosis predicted for an increased risk for a cancer recurrence, as well as reduced overall survival from breast cancer. Patients with breast cancer who have cancer cells detected in the bone marrow may wish to undergo more intensive treatment than their counterparts, as well as undergo more intense screening efforts so that a recurrence can be treated as early as possible to ensure optimal chances of a cure. Patients diagnosed with breast cancer may wish to speak with their physician about their individual risks and benefits of undergoing a bone marrow test to determine the presence or absence of cancer cells in their bone marrow.
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1.Gro Wiedswang, Elin Borgen, Rolf Kåresen, et al. Isolated Tumor Cells in Bone Marrow Three Years after Diagnosis in Disease-Free Breast Cancer Patients Predict Unfavorable Clinical Outcome. Clinical Cancer Research. 2004;10:5342-5348.
2.Braun S, Vogle F, Schlimok G, et al. Pooled analysis of prognostic impact of bone marrow micrometastasis: 10-year survival of 4199 breast cancer patients. Proceedings from the 2003 San Antonio Breast Cancer Symposium. December, 2003. Abstract #7.
3.Wiedswang G, Borgen E, Karensen R, et al. The presence of isolated tumor cells in bone marrow three years after diagnosis in disease free breast cancer patients predicts an unfavourable outcome. Proceedings from the 2003 San Antonio Breast Cancer Symposium. December 2003. Abstract #8.
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