Elucidation of interaction between bone marrow micro-metastases in breast cancer patients

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To elucidate the interaction of disseminated tumor cells in bone marrow (DTC) and bone microenvironment and the effects of bisphosphonates in early breast cancer, we treated breast cancer patients with neoadjuvant chemotherapy with zoledronic acid (ZA), and examined pathological response and changes of DTC, circulating tumor cells (CTC) and circulating endothelial cells (CEC). We treated 30 patients and had Grade 2 to 3 response in 9 patients. CTC was positive in three patients and all became negative after chemotherapy. CEC increased with chemotherapy. Chemotherapy with ZA may increase CEC, and CEC may become a biomarker of neoadjuvant chemotherapy. DTC was positive in only three patients and tumor cells were few, so it was difficult to investigate interaction between tumor cells and cells in bone micro-environment. It should be necessary to investigate interaction between tumor cells and cells in bone micro-environment in the samples of bone metastases