Micrometastatic disease in breast cancer: Clinical implications

Abstract The presence of bone marrow disseminated tumour cells (DTCs) was shown to predict poor clinical outcome in early breast cancer. However, peripheral blood is easier to obtain and allows for serial monitoring of minimal residual disease. Towards this aim, circulating tumour cells (CTCs) in th...

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Bibliographic Details
Published in:European journal of cancer (1990) 2008-12, Vol.44 (18), p.2726-2736
Main Authors: Ignatiadis, Michail, Georgoulias, Vassilis, Mavroudis, Dimitris
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Biomarkers, Tumor - metabolism
Breast cancer
Breast Neoplasms - pathology
Circulating tumour cells
CK19mRNA
Disseminated tumour cells
Female
Hematology, Oncology and Palliative Medicine
Humans
Immunocytochemistry
Micrometastatic cells
Neoplasm Metastasis - diagnosis
Neoplasm Metastasis - drug therapy
Neoplasm, Residual
Neoplastic Cells, Circulating - drug effects
Neoplastic Cells, Circulating - pathology
Prediction
Prognosis
RT-PCR
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Summary:Abstract The presence of bone marrow disseminated tumour cells (DTCs) was shown to predict poor clinical outcome in early breast cancer. However, peripheral blood is easier to obtain and allows for serial monitoring of minimal residual disease. Towards this aim, circulating tumour cells (CTCs) in the blood are detected using either direct methods, mainly antibody-based assays (immunocytochemistry, immunofluorescence and flow cytometry), or indirect methods, mainly nucleic acid-based assays (detection of mRNA transcripts by reverse transcriptase polymerase chain reaction, RT-PCR). The detection of CTCs using RT-PCR for CK19 was shown to be an independent prognostic factor in women with early breast cancer. Furthermore, considerable progress has been accomplished in genotyping, phenotyping and profiling micrometastatic cells. The challenge now is to integrate minimal residual disease as a prognostic and predictive tool in the management of breast cancer. This requires the standardisation of micrometastatic cell detection and characterisation, which will allow the incorporation of CTCs/DTCs into prospective clinical trials testing their clinical utility.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2008.09.033