The study found that the presence of circulating tumor cells (CTCs) in patients with early-stage breast cancer carried a higher risk of cancer recurrence or death. Patients with one or more CTCs had a four times greater risk, and those with three or more CTCs faced an 11.5 times higher risk of death from breast cancer. CTC levels did not correlate with lymph node status or primary tumor characteristics, suggesting CTC measurement provides additional prognostic information beyond standard analysis. However, larger studies are still needed to determine how best to use CTC information in clinical decision-making.

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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
file://C:Documents and SettingsutenteDesktopEd_lucci.htm 03/07/2012