Effect of primary anthracycline-based chemotherapy on disseminated tumor cells in locally advanced breast cancer

Background: The leading cause of death from epithelial cancer is metastatic tumor relapse due to early dissemination of tumor cells. In this study we investigated the elimination rate of disseminated tumor cells in bone marrow and the clinical response under primary chemotherapy in locally advanced breast cancer. Patients and Methods: Thirty patients underwent primary anthracycline-containing chemotherapy for breast cancer. For immunocytochemical tumor cell detection in bone marrow, the monoclonal antibody 5D3 was used. Results: At time of diagnosis, 10/30 (33%) patients had cytokeratin-positive tumor cells in bone marrow. After primary and chemotherapy, 8/30 (27%) patients still tested positive. Clinical complete response (cCR) was observed in 5/30 (17%) patients partial response (cPR) in 12/30 (40%) patients, resulting in an overall rate of clinical response to primary chemotherapy in 57%. Conclusion: Primary chemotherapy in breast cancer is effective regarding the reduction of tumor size but seems incapable of reducing the burden of disseminated tumor cells in bone marrow.