The molecular detection of micrometastatic breast cancer

Background: The rapid evolution of molecular technology and novel markers provides the opportunity to establish a more effective means to detect micrometastatic breast cancer. Given the controversies concerning application and clinical relevance, this review critically evaluates the current status of these molecular staging technologies. Data sources: Breast cancer literature addressing (1) molecular detection methodologies (immunohistochemistry, reverse transcriptase polymerase chain reaction, and microarray analysis); (2) specific tissue applications such as lymph nodes, bone marrow aspirate, and peripheral blood; (3) expert commentary concerning the clinical applications and pitfalls of these technologies; and (4) recent data from our molecular diagnostics laboratory. Conclusions: Molecular detection technologies such as reverse transcriptase polymerase chain reaction and microarray analyses are being developed that will likely have future application as cancer diagnostics. Further work is needed to establish assays that are validated by prospective clinical studies. Early identification of clinically relevant disease could lead to new treatment or staging approaches for breast cancer. (C) 2003 Excerpta Medica, Inc. All rights reserved.