Minimal Residual Disease in Breast Cancer
Janků F. , Novotný J., 1Vedralová J., 2Kleibl Z., 2Matouš B., Petruželka L.
Onkologická klinika 1. LF UK a VFN, Praha Komplexní onkologické centrum, Praha 1Ústav patologické anatomie 1. LF UK, Praha 2II. ústav lékařské chemie a biochemie 1. LF UK, Praha
The incidence of breast cancer continuously increases in developed countries. The introduction of screening
methods such as mammography or ultrasound lead to higher proportion of early diagnosed tumors. However, even
in early stage tumors occult neoplastic cells can spread to the organism. Such tumor cells are very likely precursors
of distant metastases. Using several monoclonal antibodies against epithelial mucins or cytokeratins on the cell
surface could be detected one tumor cell among 10 5 or 10 6 of normal bone marrow cells. These cells are not detectable
by routine histopathologic exam. More sensitive but also more costly and technically demanding are PCR assays.
The sensitivity might reach almost 1:10 7. Prospective clinical trials using immunocytochemistry have shown that
the presence of stained cells in bone marrow is clearly associated with shorter disease free survival and overall
survival. In the near future we may use the bone marrow examination for the presence of occult tumor cells in order
to improve current staging system or as a surrogate marker in the decision-making in regard to adjuvant systemic
therapy or in the assessment of efficacy of adjuvant treatment. The review summarizes contemporary knowledge
assembled in preclinical and clinical studies.
breast cancer, bone marrow, cytokeratin, mammaglobin, minimal residual disease.