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This Article Free to Access Full Text Full Text (PDF) All Versions of this Article: jcp.2007.046649v1 61/5/570    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Google Scholar Articles by Vincent-Salomon, A Articles by Pierga, J Y PubMed PubMed Citation Articles by Vincent-Salomon, A Articles by Pierga, J Y Pubmed/NCBI databases Medline Plus Health Information Breast Cancer Topic Collections Unlocked

Bone marrow micrometastasis in breast cancer: review of detection methods, prognostic impact and biological issues

Institut Curie, Paris, France

Correspondence to:
Dr A Vincent-Salomon, Department of Pathology, Institut Curie, 26 rue d’Ulm 75248 Paris Cedex 05, France; anne.salomon{at}curie.net

Immunocytochemical detection of disseminated tumour cells in the bone marrow of patients with primary breast cancer at surgery has been shown to be an independent prognostic factor in single institutional studies and in a large pooled analysis. However, bone marrow sampling and assessment of disseminated tumour cells is not a routine procedure in the clinical management of patients with breast cancer, but will certainly play a role in the near future for risk stratification and monitoring of therapeutic efficacy. Accurate identification of disseminated tumour cells in bone marrow must be based on standardised methodologies and procedures. This review describes these methodologies and the standardised morphological criteria used for disseminated tumour cell detection. The prognostic value of circulating tumour cells detection in peripheral blood is demonstrated in patients with metastatic disease but remains to be substantiated at early stage. The significance of disseminated tumour cells in bone marrow and in the blood for the prediction of response to therapy is briefly summarised. Finally, this review addresses the main biological questions raised by disseminated tumour cells, in particular understanding tumour dormancy and identifying metastatic stem cells.