Circulating tumor cells foretell course of nonmetastatic breast cancer

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The presence of one or more circulating tumor cells predicted both early recurrence and decreased overall survival in patients with nonmetastatic breast cancer.

Circulating tumor cells correlate with poor prognosis in metastatic breast cancer, but as Anthony Lucci, MD, of The University of Texas MD Anderson Cancer Center in Houston, and fellow researchers explained in The Lancet Oncology, few data exist describing the importance of these cells in nonmetastatic disease. To gather more information, the team prospectively collected data on circulating tumor cells at the time of surgery from MD Anderson patients with stage 1 to 3 operable breast cancer. No patient had undergone chemotherapy, had bilateral breast cancer, or had any other malignancy within 5 years of the current diagnosis.

Using a simple blood test, Lucci and colleagues ultimately identified circulating tumor cells in 73 (24%) of 302 patients. Detection of one or more cells predicted both decreased progression-free survival and overall survival, with 15% of the patients who tested positive for circulating tumor cells relapsing and 10% dying during the study period (February 2005 to December 2010). By comparison, just 3% of the patients with no circulating cells relapsed, and only 2% died.

Poor progression-free and overall survival rates were especially pronounced in persons with a higher concentration of circulating tumor cells (three or more per 7.5 mL of blood): 31% of those patients relapsed or died during the study period.

The findings point to the possibility that blood tests could be used to improve the diagnosis and treatment of patients with early-stage breast cancer.

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