The role of circulating tumor cells as a prognostic marker in the adjuvant setting of patients with breast cancer | ||||
| Journal of Current Medical Research and Practice | ||||
| Volume 5, Issue 3, July 2020, Page 241-247 PDF (783.52 K) | ||||
| DOI: 10.4103/JCMRP.JCMRP_144_18 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Summar Elmorshidy; Ola N. Abdel Fattah; Hoda H. Eissa; Douaa M. Sayed; Samir S. Mohamed | ||||
| Abstract | ||||
| Background Still, there is no clinically reliable marker to detect micrometastasis or breast cancer relapse. This study aimed to evaluate the role of circulating tumor cells (CTCs) as a biomarker in patients with nonmetastatic breast cancer. Patients and methods CTC quantification was carried out using flow cytometry for 50 patients with breast cancer postoperatively: before starting, after three cycles, and at the end of adjuvant chemotherapy. The relationship between CTCs and other tumor characteristics and outcomes were studied. Results The median follow-up duration was 35 months. Before starting adjuvant chemotherapy, CTCs were positive (cutoff point ≥5/7.5 ml) in 36% of the patients and decreased to 20% after finishing chemotherapy ( = 0.04). CTCs were detected in 88.9% ( = 16 of 18) of node-positive patients and in 11.1% of node-negative patients ( = 2 of 18, = 0.04). No significant association was found with tumor size, grading, or hormone receptor status. Distant metastasis was detected in 20% ( = 10 of 50) of patients and was significantly associated with CTCs more than or equal to 5 in 80% of them ( = 8 of 10) ( = 0.01). The presence of more than or equal to 5 CTCs at baseline was associated with a reduction in both the disease-free survival and overall survival ( < 0.001 and = 0.003, respectively). Baseline CTCs more than or equal to 5/7.5 ml were confirmed as an independent prognostic factor in multivariate Cox hazard regression analysis for disease-free survival (hazard ratio = 3.71; 95% confidence interval = 1.62–8.48; = 0.002) and overall survival (hazard ratio = 3.14; 95% confidence interval = 1.34–7.37; = 0.009). Conclusions The current work suggested that the presence of more than or equal to 5 CTCs/7.5 ml at baseline would predict early disease recurrence and reduce the overall survival in patients with nonmetastatic breast cancer receiving adjuvant chemotherapy. | ||||
| Keywords | ||||
| Circulating tumor cells; Early breast cancer; prognostic factors in breast cancer | ||||
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