Selecting Patients for More Adjuvant Breast Cancer Therapy

The presence of disseminated tumor cells (DTCs) in the bone marrow is a prognostic factor for patients with early-stage breast cancer who have no other evidence of clinically apparent distant metastatic disease. However, not all individuals with early-stage breast cancer and DTCs in the bone marrow will develop a relapse. Fundamental questions include whether the number of DTCs, if present, change with adjuvant therapy, what the clinical importance of persistent DTCs is, and whether anything meaningful can be done therapeutically to improve outcome if DTCs persist post–adjuvant therapy.

To address these questions, Norwegian investigators conducted a prospective, multicenter, nonrandomized study involving 1121 patients (age, 18–70 years) with…