Circulating tumor cells have prognostic value in early breast cancer
MedWire News: Just one circulating tumor cell (CTC) in the blood before chemotherapy may double the risk for disease recurrence and death after treatment among women with early stage breast cancer, study findings indicate.
Moreover, patient outcome correlates with the number of CTCs: women with five or more CTCs in the blood had a four-fold greater risk for breast cancer recurrence than those with no CTCs, the researchers report.
The benefit of using CTCs to predict the risk for recurrence and death in metastatic breast cancer patients has been shown in a number of studies, explained lead researcher Brigitte Rack (University of Munich, Germany) at the 33rd Annual Cancer Therapy and Research Center-American Association for Cancer Research San Antonio Breast Cancer Symposium, held in Texas, USA.
To determine the prognostic value of CTCs in early breast cancer, Rack and colleagues analyzed peripheral blood taken from 2026 women with early-stage breast cancer (pT1-4, pN0-3, pM0) after primary tumor resection, but before the start of adjuvant systemic treatment.
A total of 435 (21.5%) patients had at least one CTC (median=1.3) in their blood, and these women were more frequently node-positive than women without CTCs. However, CTCs did not correlate with patients' tumor size, grading, or hormone-receptor status.
During a median follow-up period of 35 months, the breast cancer recurrence rate among women with at least one CTC was 11.7% and the death rate was 6.2%. Women without CTCs had respective rates of 5.3% and 2.5%.
These findings corresponded to a 1.88- and 1.91-fold increased risk for earlier disease recurrence and death, respectively, among women with at least one CTC compared with those with none, report Rack et al.
Prognosis was worse in patients with five or more CTCs as these patients had a 4.04-fold increased risk for recurrence and a 3.05-fold increased risk for death compared with women with no CTCs.
"Our study suggests [that] testing CTCs may prove to be important to help individualize therapy for early-stage breast cancer where no measurable tumor is present," said Rack.
"Patients who seem to be at high risk due to CTCs may benefit from additional treatment options, and those that don't have CTCs may be spared side effects of some treatments," she concluded.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Laura Dean