Prognostic relevance of disseminated tumor cells in the bone marrow and biological factors of 265 primary breast carcinomas

Introduction The prognostic significance of disseminated tumor
cells in the bone marrow (DTC-BM) of breast cancer patients has
been demonstrated in many studies. Yet, it is not clear which of
the primary tumors' biological factors predict hematogenous
dissemination. We therefore examined `tissue micro arrays' (TMAs)
of 265 primary breast carcinomas from patients with known bone
marrow ( BM) status for HER2, Topoisomerase IIa ( Top IIa), Ki 67,
and p53. Methods BM analysis was performed by cytospin preparation
and immunocytochemical staining for cytokeratin (CK). TMAs were
examined by immunohistochemistry (IHC) for HER2, Top IIa, Ki 67 and
p53, and fluorescence in situ hybridization ( FISH) for HER2.
Results HER2 ( 2+/ 3+) was positive in 35/167 (21%) cases ( FISH
24.3%), Top IIa (> 10%) in 87/187 (46%), Ki 67 in 52/ 184 (28%)
and p53 (> 5%) in 61/174 cases (34%). Of 265 patients, 68
(25.7%) showed DTC-BM with a median of 2/2 x 106 cells ( 1 to
1,500). None of the examined factors significantly predicted BM
positivity. Significant correlation was seen between HER2 IHC and
Top IIa ( p = 0.06), Ki 67 ( p = 0.031), and p53 ( p