Intraoperative bone marrow puncture in breast cancer patients: Prospective assessment of adverse side-effects

Domschke, Christoph; Neubrech, Florian; Dick, Michelle; Rom, Joachim; Beckhove, Philipp; Sohn, Christof; Schuetz, Florian; Scharf, Alexander

doi:10.1016/j.breast.2010.06.007

« Previous Next »The Breast
Volume 20, Issue 1 , Pages 62-65, February 2011

Intraoperative bone marrow puncture in breast cancer patients: Prospective assessment of adverse side-effects

Christoph Domschke
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
- Corresponding author. Tel.: +49 6221 5637330; fax: +49 6221 565233.
Florian Neubrech
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
Michelle Dick
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
Joachim Rom
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
Philipp Beckhove
- Division of Translational Immunology, Tumor Immunology Program, German Cancer Research Center (DKFZ), INF 280, 69120 Heidelberg, Germany
Christof Sohn
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
Florian Schuetz
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany
Alexander Scharf
- Department of Gynecology and Obstetrics, University Hospital of Heidelberg, Voßstraße 9, 69115 Heidelberg, Germany

Received 31 December 2009; received in revised form 2 March 2010; accepted 17 June 2010. published online 12 July 2010.

Abstract

Background and aim

In breast cancer patients, intraoperative bone marrow puncture (BMP) with positive detection of disseminated tumor cells has been reported to predict unfavorable clinical outcome due to increased risk of recurrence. In this study, we prospectively assessed BMP-associated untoward side-effects.

Methods

Fifty-eight consecutive breast cancer patients were prospectively explored after intraoperative BMP for postoperative pain (visual analogue scale, VAS) and complications in terms of infection, hematoma, and sensibility disorder. Furthermore, the impact of BMP on hospital stay duration was analyzed in 254 patients.

Results

In all subgroups analyzed, during five postoperative days patients complained about minor pain only at the site of BMP (VAS < 1) while the corresponding pain scores were significantly higher for the area of the operated breast. Post-BMP iliac crest hematomas were encountered in 13 out of 58 patients (22.4%) who were significantly older (p = 0.04), less frequently smokers (p = 0.02), and presented with higher body mass index (p = 0.01) than controls. Within the area of BMP no signs of infection or sensibility disorders were observed. Comparison of patients with and without BMP did not show any significant difference in postoperative hospital stay duration.

Conclusion

Referring to the potential clinical benefit of intraoperative BMP its prospectively assessed adverse side-effects appear relatively mild and thus acceptable.

Keywords: Breast cancer, DTCs, Bone marrow puncture, Side-effects