The relevance of performing a bone marrow aspirate and biopsy in breast cancer patients with suspected bone marrow metastasis

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18605 Background: Patients with breast cancer often presents hematological abnormalities during the disease evolution, frequently it is difficult to define if these are due to bone marrow infiltartion or are due to drug toxicity or a new hematological disorder. To determine the proportion of patients with bone marrow metastasis we reviewed the bone marrow aspirates and biopsies of patients with histological proven breast cancer and an abnormal peripheral blood count referred to the Hematology Department. Methods: We reviewed the medical records of 88 patients referred to our Department from april 1998 to april 2005 with breast cancer and with bone marrow smears and biopsies. The BM smears were interpreted blindly by one of us. The BM biopsies were reviewed independently by a hematopatologist. A statistician analysed the data and estimated frequencies and rates, survival analysis was estimated by means of the Kaplan-Meier method. Results: Median age 47.7 years (range 28–80), clinical stage at diagnosis was: II, 19 (21.1%); IIIA, 19 (21.1%); IIIB, 16 (17.8%); IV, 34 (40%). The hematological abnormality that triggered the referral was: Thrombocytopenia, 61 (67.8%); anemia, 53 (58.9%); leucopenia, 47 (53.4%); thrombocytopenia and anemia, 39 (43.3%). The median time from the initial diagnosis to the BM biopsy was 12.8 months (range 1 to 176.7). Regarding the BM aspirates interpretatrion: 17 were not evaluable, 53 were negative for infiltration, 17 were positive for carcinoma and 1 with plasma cell infiltration (this patients had concurrent Breast cancer and myeloma). BM biopsies: 19 were not evaluable, 48 were negative, 20 positive and 1 with myeloma. The sensitivity of the BM aspirates was 75% (12/16) and the specificity 95% (41/43). The median survival of the patients with BM metastais was 109 months, and 104 of the patients without BM metastasis (p = 0.9767) Conclusions: Most of the patients with hematological abnormalities do not have BM infiltration, bone marrow biopsies have more sensitivity than aspirates. The presence of BM metastasis does not necessarily predicts a short survival period. No significant financial relationships to disclose.