Importance of circulating tumour cells in patients with non-metastatic breast cancer

The results of our study showed that presence of one or more circulating tumor cells (CTCs) in patients with stage I-III breast cancer carried a four times greater chance of a recurrence or death. Increasing numbers of CTCs carried even higher hazard ratios, as patients with three or more CTCs had an 11.5 times higher risk of dying from their breast cancer. CTCs also did not correlate with axillary lymph node status or primary tumor characteristics, suggesting that CTC measurement might provide complementary information to standard primary tumor analysis and lymph node staging. The caveat to this study is we now have a prognostic marker that we don’t really know how to best use in clinical decision–making. Larger studies will be needed to identify subgroups wherein information on CTCs can help guide treatment decisions. An example would be the group of estrogen receptor-positive, lymph node-negative patients, where oftentimes the benefit for chemotherapy is not completely clear. Future studies will no doubt shed light on when the information from CTCs can be used in the clinic to optimize therapy, but for now we believe the test is still best utilized in clinical studies where we can gather such information  

Bibliographic Reference:

Lucci A et al.: "Circulating tumour cells in non-metastatic breast cancer: a prospective study", Lancet Oncol. 2012 Jun 1. [Epub ahead of print]

Anthony Lucci

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA