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Characterisation of these cells could help understand the known limitations of adjuvant therapy. Of particular interest is their oestrogen-receptor (ER) status because endocrine adjuvant therapy remains a cornerstone of breast cancer treatment.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>Bone marrow (BM) aspirates from 254 patients with primary breast cancer were included in this study. A double immunofluorescence staining procedure was established for the identification of cytokeratin (CK) positive\/Er\u03b1-positive cells. ER\u03b1 status of the primary tumour was assessed immunohistochemically using the same antibody against ER\u03b1.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>In 107 of 254 (42%) breast cancer patients, CK-positive cells could be detected in the BM. More than one DTC in the BM was observed in 38 of the 107 patients. The number of detected cells ranged between 1 and 55 cells per 2 \u00d7 10<jats:sup>6<\/jats:sup> mononuclear cells. DTCs demonstrated ER\u03b1 positivity in 12% of the patients. The ER\u03b1 expression was heterogeneous in 10 of the 38 (26%) patients with more than one DTC. The concordance rate of ER\u03b1 status between primary tumour and DTC was 28%. Only 12 of 88 patients with ER\u03b1-positive tumours also had ER\u03b1-positive DTCs.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Primary tumours and DTCs displayed a concordant ER\u03b1 status in only 28% of cases. Most of the DTCs were ER\u03b1 negative despite the presence of an ER\u03b1-positive primary tumour. These findings further underline the distinct nature of DTCs and may explain the failure rates seen in conventional endocrine adjuvant therapy.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/bcr2143","type":"journal-article","created":{"date-parts":[[2008,9,16]],"date-time":"2008-09-16T06:13:49Z","timestamp":1221545629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["ERalpha-status of disseminated tumour cells in bone marrow of primary breast cancer patients"],"prefix":"10.1186","volume":"10","author":[{"given":"Tanja","family":"Fehm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Krawczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich-Franz","family":"Solomayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziella","family":"Becker-Pergola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"D\u00fcrr-St\u00f6rzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Neubauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Seeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Staebler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diethelm","family":"Wallwiener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2008,9,15]]},"reference":[{"key":"2107_CR1","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1093\/jnci\/88.22.1652","volume":"88","author":"IJ Diel","year":"1996","unstructured":"Diel IJ, Kaufmann M, Costa SD, Holle R, von Minckwitz G, Solomayer EF, Kaul S, Bastert G: Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comparison with nodal status. 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