Tracing the Seeds in the Soil.

Abstract

Featured Article: Braun S, Vogl FD, Naume B, Janni W, Osborne MP, Coombes RC et al. A pooled analysis of BM micrometastasis in breast cancer. N Engl J Med. 2005;353:793–802.2 In our article featured here, we reported in a pooled analysis of >4700 patients with primary breast cancer (stage M0) that the presence of disseminated tumor cells (DTCs)3 in the bone marrow (BM) at the time of diagnosis was an independent predictor of poor prognosis. Metastasis formation in secondary organs, which is the major cause of death from solid tumors, originates from tumor seeds released from the primary lesion before it is removed by the surgeon. Our initial efforts to trace DTCs in BM were largely motivated by the fact that the bones are major sites of distant metastasis in breast cancer (and other solid tumors such as prostate and lung cancer). Moreover, the BM is accessible by needle aspiration, an invasive but safe diagnostic approach used for decades in patients with hematological malignancies. Finally, the BM is a mesenchymal organ, and breast cancers (as most other …