The test has been validated in ER-positive, HER2-negative, lymph node-negative or micrometastatic
patients and allows for predicting which patients would derive minimal or no benefit from adjuvant chemotherapy and may be safely spared from it, thus avoiding toxicity and cost, without compromising outcomes (13).
There is increasing evidence that many small, nonmetastatic or micrometastatic
cancers are Dr H.
Its main limitation is low sensitivity for micrometastatic
Two-thirds of our patients presented with a locally advanced breast cancer (stage 2a 3c) with disease in both the breast and axilla, with a high risk of systemic micrometastatic
Oral field cancerization: carcinogen-induced independent events or micrometastatic
The sensitivity was 40.9% in micrometastatic
lymph nodes with (metastasis >2 mm) and 52.9% in those with (metastasis >5 mm) (9).
However, based on the premise that CTCs could be shed not only from tumor masses but also from premalignant lesions, micrometastatic
foci, and reservoirs of dormant cancer cells, information obtained from the genomic interrogation of these disparate CTC subsets have the potential to unravel the complete clonal hierarchy of neoplastic cells.
The potential advantages of perioperative therapy include treatment of possible micrometastatic
disease, testing of the biological behavior of the tumor (patients with early progression on chemotherapy might be spared subsequent morbid surgery), and possible facilitation of the surgical resection.
The mechanism behind this benefit remains unclear but may result from inhibiting progression of metastatic disease, preventing additional metastatic seeding, or through an immunostimulatory abscopal effect on micrometastatic
There is now emerging evidence that a subset of patients, categorized as borderline resectable (BR), may benefit from resection after neoadjuvant therapy due to the theoretical benefits of downstaging the tumor, treating subclinical micrometastatic
disease, increasing the proportion of patients who will receive and complete therapy, and the ability to better monitor the tumor's response to therapy [5, 6].
disease with local T cell response can explain our findings as well.
, who see metastases at the time of implantation as a contraindication, but it must be taken into account that only 10-20% of patients have macroscopic evidence of metastatic disease, whereas 80-90% of patients with osteosarcoma are assumed to have micrometastatic
disease at initial diagnosis .