New Breast Cancer Marker May Predict Metastases

A new marker for breast cancer metastases has been identified.

The marker is called tumor microenvironment of metastasis or TMEM. The density of TMEM was associated with the development of distant organ metastasis via the bloodstream--the most common cause of death from breast cancer.

Weill Cornell (New York, NY, USA) investigators based their study on the previous work carried out at the Albert Einstein College of Medicine (Bronx, NY, USA). Working in animal models a link had been discovered between blood-borne or systemic metastasis and a three-part association between invasive carcinoma cells, perivascular white blood cells (macrophages) and the endothelial cells that line vessel walls.

To confirm this finding in humans, Dr. Joan Jones, professor of clinical pathology and laboratory medicine at Weill Cornell Medical College and director of Anatomic Pathology at New York-Presbyterian Hospital/Weill Cornell Medical Center (New York, NY, USA) and Dr. Brian D. Robinson, resident in Anatomic Pathology at New York-Presbyterian Hospital/Weill Cornell Medical Center and colleagues developed a triple immunostain for human breast cancer samples that simultaneously labels the three cell types that together they named TMEM.

In a case-control study, the investigators performed a retrospective analysis of tissue samples from 30 patients with invasive ductal carcinoma of the breast who developed systemic, distant-organ metastases. These samples were compared to matched controls that had only localized disease (i.e., invasive ductal carcinoma limited to the breast or with regional lymph node metastasis only).

TMEM density was more than double in the group of patients who developed systemic metastases compared with the patients with only localized breast cancer. The investigators found that in well-differentiated tumors, where the outcome is generally good, the TMEM count was low.

"If patients can be better classified as either low risk or high risk for metastasis, therapies can be custom tailored to patients, preventing overtreatment or undertreatment of the disease," said Dr. Brian D. Robinson.

The study was reported in the March 24, 2009 online edition of the journal Clinical Cancer Research.

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Weill Cornell
Albert Einstein College of Medicine
New York-Presbyterian Hospital