Circulating tumour cells in non-metastatic breast cancer: a prospective study
The Lancet Oncology, 06/07/2012
Lucci A et al. – The presence of one or more circulating tumour cells predicted early recurrence and decreased overall survival in chemonaive patients with non-metastatic breast cancer.
Methods- We prospectively collected data on circulating tumour cells at the time of definitive surgery from chemonaive patients with stage 1—3 breast cancer from February, 2005, to December, 2010.
- We deemed eligible all patients with operable breast cancer presenting at The University of Texas MD Anderson Cancer Center (Houston, TX, USA).
- Patients were ineligible if they had bilateral breast cancer or any other malignancy within 5 years of the diagnosis of the present cancer. We measured circulating tumour cells with the CellSearch System (Veridex, Raritan, NJ).
- We correlated findings of circulating tumour cells with standard tumour characteristics, including tumour size and grade; oestrogen and progesterone receptor and human epidural growth factor receptor 2 (HER2) status; and axillary lymph node status with ?2 or Fisher exact tests.
- We assessed outcomes at a median follow-up of 35 months.
- Log-rank test and Cox regression analysis was applied to establish the association of circulating tumour cells with progression-free and overall survival.
- No patients reported adverse events or complications from blood collections.
- We identified one or more circulating tumour cells in 73 (24%) of 302 patients.
- Detection of one or more circulating tumour cells predicted both decreased progression-free survival (log-rank p=0·005; hazard ratio [HR] 4·62, 95% CI 1·79—11·9) and overall survival (log-rank p=0·01; HR 4·04, 1·28—12·8).
