Detection of occult metastasis in patients with breast cancer

The most important factor affecting the outcome of patients with invasive c ancer is whether the tumor has spread, either regionally (to regional lymph nodes) or systemically. However, a proportion of patients with no evidence of systemic dissemination will develop recurrent disease after primary "cu rative" therapy. Clearly, these patients had occult systemic spread of dise ase that was undetectable by routinely employed methods (careful pathologic al, clinical, biochemical, and radiological evaluation). In addition, the s uccess of adjuvant therapy is assumed to stem from its ability to eradicate occult metastases before they become clinically evident [1]. Therefore, me thods for the detection of occult metastases in patients with the earliest stage of cancer, i.e., prior to detection of metastases by any other clinic al or pathological analysis, have received a great deal of attention. (C) 2 001 Wiley-Liss, Inc.