Abstract
Tumor cell dissemination is a common phenomenon observed in most cancers of epithelial origin. One-third of breast cancer patients present with disseminated tumor cells (DTCs) in bone marrow at time of diagnosis; these patients, as well as patients with persistent DTCs, have significantly worse clinical outcome than DTC-negative patients. Since DTC phenotype may differ from the primary tumor with regard to ER and HER2 status, reevaluation of predictive markers on DTCs may optimize treatment choices. In the present review, we report on the clinical relevance of DTC detection in breast cancer.
Highlights
The speculations on dissemination patterns of solid malignancies and the role of microenvironment in disease progression were made by several researchers in 19th century [1,2]
Cancers 2014, 6 part of current translational research focuses on detection of circulating tumor cells (CTCs) in the blood, the first valid prognostic data on minimal residual disease in breast cancer were provided by studies on disseminated tumor cells (DTCs) in bone marrow
The concentration of DTCs in the bone marrow is low, estimated at one tumor cell per 107–108 blood cells in patients with advanced cancer; some protocols contain an enrichment step [4,5]: (1) density gradient centrifugation where mononuclear cells are separated from other blood cells; (2) positive selection where tumor cells are enriched through the use of an antibody targeted against a tumor cell marker or (3) negative selection where the antibody is targeted against a leukocyte antigen (e.g., CD45)
Summary
The speculations on dissemination patterns of solid malignancies and the role of microenvironment in disease progression were made by several researchers in 19th century [1,2]. The presence of minimal residual disease (MRD) may influence the patient's prognosis despite successful tumor excision and completed adjuvant therapy. Isolated tumor cells can be searched for in two main compartments; cancer cells detected in peripheral blood are described as circulating tumor cells (CTCs), while those in the bone marrow are called disseminated tumor cells (DTCs). Cancers 2014, 6 part of current translational research focuses on detection of CTCs in the blood, the first valid prognostic data on minimal residual disease in breast cancer were provided by studies on DTCs in bone marrow. The aim of this review is to give an account of current findings on tumor cell dissemination into bone marrow in breast cancer patients, with respect to the features of DTCs, their clinical impact and future possibilities
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