1. Bone marrow micrometastases in early breast cancer-30-year outcome.
- Author
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Mansi J, Morden J, Bliss JM, Neville M, and Coombes RC
- Subjects
- Aged, Bone Marrow Neoplasms metabolism, Bone Marrow Neoplasms therapy, Breast Neoplasms mortality, Breast Neoplasms therapy, Chemotherapy, Adjuvant, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Middle Aged, Mucin-1 metabolism, Prognosis, Proportional Hazards Models, Tumor Burden, Bone Marrow Neoplasms secondary, Breast Neoplasms pathology, Neoplasm Micrometastasis
- Abstract
Background: Micrometastases in bone marrow of women with early breast cancer were first identified immunocytochemically in the 1980s. We report on the original cohort of women with a median follow-up of 30 years., Patients and Methods: In total, 350 women with primary breast cancer had eight bone marrow aspirates examined with antibody to epithelial membrane antigen. Data on long-term mortality were obtained via record linkage to death certification., Results: At a 30-year median follow-up, 79 out of 89 (89%) patients with micrometastases have died compared with 202 out of 261 (77%) without (hazard ratio=1.46 (95% CI 1.12-1.90), P=0.0043). Most marked effect of micrometastases on overall survival (OS) was seen in patients aged ⩽ 50 at surgery (N=97, P=0.012), and on all patients within 10 years of diagnosis. In multivariable analyses, the presence of micrometastases was no longer a statistically significant prognostic factor., Conclusions: Bone marrow micrometastases are predictive for OS, particularly in the first decade and in younger patients.
- Published
- 2016
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