Detecting Breast Cancer Cells in the Blood and Bone Marrow: Which Technology is Better?

The development of techniques to detect minute amounts of cancer cells, called micrometastases (MM), in the blood or bone marrow of patients initially promised to revolutionize the management of many cancers, including breast cancer. Yet despite two decades of research in this area, the biological significance, prognostic significance, and clinical utility of MM detection have not been fully established. While various studies have attempted to develop and optimize techniques of MM detection, they have not been able to show correlation with clinical outcome, and the method by which MM are detected appears to be a critical variable. Furthermore, new technologies have been developed, called Flow Cytometry and Reverse Transcriptase-PCR that can also be tested. The Breast Care Center at UCSF/Mount Zion has decided to conduct a large study to address these issues.

Micrometastases, individual cancer cells that have disassociated from the primary tumor, may be involved in the process of cancer spreading. For example, these cancer cells may spread to other parts of the body, and then later form a new tumor, even if the breast tumor is removed. Doctors John Park, Laura Esserman and associates at the UCSF Mount Zion Breast Care Center are conducting a research study aimed at developing and testing methods, including the newer techniques mentioned above, to detect and monitor these cancer cells in the blood and bone marrow of breast cancer patients.

Why is this study important?

By studying the number and types of cancer cells travelling in the body and correlating this with a patientís clinical outcome, researchers may gain a better understanding of how cancer spreads throughout the body. Patients and doctors may also use this information to decide which treatment is best for the patient, and may be able to monitor how well a given treatment is working. All of this may improve treatment results.

What does this study entail?

This study will use blood and bone marrow samples from stage I, II, and III breast cancer patients. The bone marrow sample will be obtained when the patient is already anesthetized for surgery on her primary breast tumor, and will thus place a minimal additional burden on the patient.