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Erschienen in: Annals of Surgical Oncology 6/2010

01.06.2010 | Breast Oncology

Changes in Circulating Tumor Cell Detection in Patients with Localized Breast Cancer Before and After Surgery

verfasst von: Maria T. Sandri, MD, Laura Zorzino, DSc, Maria C. Cassatella, DSc, Fabio Bassi, MD, Alberto Luini, MD, Chiara Casadio, MD, Edoardo Botteri, PhD, Nicole Rotmensz, PhD, Laura Adamoli, PhD, Franco Nolè, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 6/2010

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Abstract

Background

Few data exist on the potential role of circulating tumor cells (CTCs) in patients with operable breast cancer. If the presence of CTCs in early breast cancer could predict an increased risk for relapse, it might be an early marker for treatment efficacy and could help in deciding treatment continuation.

Methods

Thirty milliliters of peripheral blood was taken from 56 breast cancer patients before surgery and again 5 days after surgery, and the presence of CTCs was evaluated. In case of positivity of one of the perioperative samples, another sample was taken after 30 days. The presence of CTCs was assessed with the CellSearch System (Veridex, Warren, NJ).

Results

One to three CTCs were found in 16 (29%) of 56 patients before surgery, in 14 (30%) of 47 patients at day 5, and in 8 (30%) of 27 at day 30. No association with pathological characteristics was found, apart a borderline significant association between presence of CTCs at baseline and vascular invasion (P = 0.07). When we looked at concordance between CTCs at baseline and after day 5 (47 patients), we found 40% discordant samples (10 negative at baseline and positive at day 5, and 9 vice versa).

Conclusions

This study provides evidence of the presence of CTCs in approximately 30% of patients with localized breast cancer both before and after surgery, with change from positive to negative and vice versa in 40% of cases. No association with the pathological variables was found, except for vascular invasion and presence of preoperative CTCs. Long-term follow-up will be required to understand the significance of these data.
Literatur
1.
Zurück zum Zitat Ashworth TR. A case of cancer in which cells similar to those in the tumors were seen in the blood after death. Aust Med J. 1869;14:146–9. Ashworth TR. A case of cancer in which cells similar to those in the tumors were seen in the blood after death. Aust Med J. 1869;14:146–9.
2.
Zurück zum Zitat Paterlini-Brechot P, Benali NL. Circulating tumor cells (CTC) detection: clinical impact and future directions. Cancer Lett. 2007;253:180–204.CrossRefPubMed Paterlini-Brechot P, Benali NL. Circulating tumor cells (CTC) detection: clinical impact and future directions. Cancer Lett. 2007;253:180–204.CrossRefPubMed
3.
Zurück zum Zitat Mocellin S, Keilholz U, Rossi CR, Nitti D. Circulating tumor cells: the “leukemic phase” of solid cancers. Trends Mol Med. 2006;12:130–9.CrossRefPubMed Mocellin S, Keilholz U, Rossi CR, Nitti D. Circulating tumor cells: the “leukemic phase” of solid cancers. Trends Mol Med. 2006;12:130–9.CrossRefPubMed
4.
Zurück zum Zitat Cristofanilli M, Budd GT, Ellis MJ, et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med. 2004;351:781–9.CrossRefPubMed Cristofanilli M, Budd GT, Ellis MJ, et al. Circulating tumor cells, disease progression, and survival in metastatic breast cancer. N Engl J Med. 2004;351:781–9.CrossRefPubMed
5.
Zurück zum Zitat Cristofanilli M, Hayes DF, Budd GT, et al. Circulating tumor cells: a novel prognostic factor for newly diagnosed metastatic breast cancer. J Clin Oncol. 2005;23:1420–30.CrossRefPubMed Cristofanilli M, Hayes DF, Budd GT, et al. Circulating tumor cells: a novel prognostic factor for newly diagnosed metastatic breast cancer. J Clin Oncol. 2005;23:1420–30.CrossRefPubMed
6.
Zurück zum Zitat Danila DC, Heller G, Gignac GA, et al. Circulating tumor cell number and prognosis in progressive castration-resistant prostate cancer. Clin Cancer Res. 2007;13:7053–8.CrossRefPubMed Danila DC, Heller G, Gignac GA, et al. Circulating tumor cell number and prognosis in progressive castration-resistant prostate cancer. Clin Cancer Res. 2007;13:7053–8.CrossRefPubMed
7.
Zurück zum Zitat Cohen SJ, Punt CJA, Iannotti N, et al. Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol. 2008;19:3213–21.CrossRef Cohen SJ, Punt CJA, Iannotti N, et al. Relationship of circulating tumor cells to tumor response, progression-free survival, and overall survival in patients with metastatic colorectal cancer. J Clin Oncol. 2008;19:3213–21.CrossRef
8.
Zurück zum Zitat Nolè F, Munzone E, Zorzino L, et al. Variation of circulating tumor cell levels during treatment of metastatic breast cancer: prognostic and therapeutic implications. Ann Oncol. 2008;19:891–7.CrossRefPubMed Nolè F, Munzone E, Zorzino L, et al. Variation of circulating tumor cell levels during treatment of metastatic breast cancer: prognostic and therapeutic implications. Ann Oncol. 2008;19:891–7.CrossRefPubMed
9.
Zurück zum Zitat Paget S. Distribution of secondary growths in cancer of the breast. Lancet 1889;1:571.CrossRef Paget S. Distribution of secondary growths in cancer of the breast. Lancet 1889;1:571.CrossRef
10.
Zurück zum Zitat Ignatiadis M, Kallergi G, Ntoulia M, et al. Prognostic value of the molecular detection of circulating tumor cells using a multimarker reverse transcription–PCR assay for cytokeratin 19, mammoglobin A, and HER2 in early breast cancer. Clin Cancer Res. 2008;14:2593–600.CrossRefPubMed Ignatiadis M, Kallergi G, Ntoulia M, et al. Prognostic value of the molecular detection of circulating tumor cells using a multimarker reverse transcription–PCR assay for cytokeratin 19, mammoglobin A, and HER2 in early breast cancer. Clin Cancer Res. 2008;14:2593–600.CrossRefPubMed
11.
Zurück zum Zitat Zach O, Kasparu H, Wagner H, Krieger O, Lutz D. Prognostic value of tumour cell detection in peripheral blood of breast cancer patients. Acta Med Austriaca Suppl. 2002;59:32–4.PubMed Zach O, Kasparu H, Wagner H, Krieger O, Lutz D. Prognostic value of tumour cell detection in peripheral blood of breast cancer patients. Acta Med Austriaca Suppl. 2002;59:32–4.PubMed
12.
Zurück zum Zitat Gaforio JJ, Serrano MJ, Sanchez-Rovira P, et al. Detection of breast cancer cells in the peripheral blood is positively correlated with estrogen-receptor status and predicts for poor prognosis. Int J Cancer. 2003;7:984–90.CrossRef Gaforio JJ, Serrano MJ, Sanchez-Rovira P, et al. Detection of breast cancer cells in the peripheral blood is positively correlated with estrogen-receptor status and predicts for poor prognosis. Int J Cancer. 2003;7:984–90.CrossRef
13.
Zurück zum Zitat Pierga JY, Bonneton C, Vincent-Salomon A, et al. Clinical significance of immunocytochemical detection of tumor cells using digital microscopy in peripheral blood and bone marrow of breast cancer patients. Clin Cancer Res. 2001;10:1392–400.CrossRef Pierga JY, Bonneton C, Vincent-Salomon A, et al. Clinical significance of immunocytochemical detection of tumor cells using digital microscopy in peripheral blood and bone marrow of breast cancer patients. Clin Cancer Res. 2001;10:1392–400.CrossRef
14.
Zurück zum Zitat Benoy IH, Elst H, Philips M, et al. Real-time RT-PCR detection of disseminated tumour cells in bone marrow has superior prognostic significance in comparison with circulating tumour cells in patients with breast cancer. Br J Cancer. 2006;94:672–80.PubMed Benoy IH, Elst H, Philips M, et al. Real-time RT-PCR detection of disseminated tumour cells in bone marrow has superior prognostic significance in comparison with circulating tumour cells in patients with breast cancer. Br J Cancer. 2006;94:672–80.PubMed
15.
Zurück zum Zitat Stathopoulos EN, Sanidas E, Kafousi M, et al. Detection of CK-19 mRNA-positive cells in the peripheral blood of breast cancer patients with histologically and immunohistochemically negative axillary lymph nodes. Ann Oncol. 2005;16:240–6.CrossRefPubMed Stathopoulos EN, Sanidas E, Kafousi M, et al. Detection of CK-19 mRNA-positive cells in the peripheral blood of breast cancer patients with histologically and immunohistochemically negative axillary lymph nodes. Ann Oncol. 2005;16:240–6.CrossRefPubMed
16.
Zurück zum Zitat Fidler IJ. The pathogenesis of cancer metastasis: the “seed and soil” hypothesis revisited. Nat Rev Cancer. 2003;3:453–8.CrossRefPubMed Fidler IJ. The pathogenesis of cancer metastasis: the “seed and soil” hypothesis revisited. Nat Rev Cancer. 2003;3:453–8.CrossRefPubMed
17.
Zurück zum Zitat Lang JE, Mosalpuria K, Cristofanilli M, et al. HER2 status predicts the presence of circulating tumor cells in patients with operable breast cancer. Breast Cancer Res Treat. 2009;113:501–7.CrossRefPubMed Lang JE, Mosalpuria K, Cristofanilli M, et al. HER2 status predicts the presence of circulating tumor cells in patients with operable breast cancer. Breast Cancer Res Treat. 2009;113:501–7.CrossRefPubMed
18.
Zurück zum Zitat Allard WJ, Matera J, Miller MC, et al. Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with non-malignant diseases. Clin Cancer Res. 2004;10:6897–904.CrossRefPubMed Allard WJ, Matera J, Miller MC, et al. Tumor cells circulate in the peripheral blood of all major carcinomas but not in healthy subjects or patients with non-malignant diseases. Clin Cancer Res. 2004;10:6897–904.CrossRefPubMed
19.
Zurück zum Zitat Zhu L, Loo WTY, Chow LWC. Circulating tumor cells in patients with breast cancer: possible predictor of micro-metastasis in bone marrow but not in sentinel lymph nodes. Biomed Pharmacother. 2005;59:S355–8.CrossRefPubMed Zhu L, Loo WTY, Chow LWC. Circulating tumor cells in patients with breast cancer: possible predictor of micro-metastasis in bone marrow but not in sentinel lymph nodes. Biomed Pharmacother. 2005;59:S355–8.CrossRefPubMed
20.
Zurück zum Zitat Wulfing P, Borchard J, Buerger H, et al. Her-2 positive circulating tumor cells indicate poor clinical outcome in stage I to III breast cancer patients. Clin Cancer Res. 2006;12:1715–20.CrossRefPubMed Wulfing P, Borchard J, Buerger H, et al. Her-2 positive circulating tumor cells indicate poor clinical outcome in stage I to III breast cancer patients. Clin Cancer Res. 2006;12:1715–20.CrossRefPubMed
21.
Zurück zum Zitat Biggers B, Knox S, Grant M, et al. Circulating tumor cells in patients undergoing surgery for primary breast cancer: preliminary results of a pilot study. Ann Surg Oncol. 2009;16:969–71.CrossRefPubMed Biggers B, Knox S, Grant M, et al. Circulating tumor cells in patients undergoing surgery for primary breast cancer: preliminary results of a pilot study. Ann Surg Oncol. 2009;16:969–71.CrossRefPubMed
22.
Zurück zum Zitat Meng S, Tripathy D, Frenkel EP, et al. Circulating tumor cells in patients with breast cancer dormancy. Clin Cancer Res. 2004;10:8152–62.CrossRefPubMed Meng S, Tripathy D, Frenkel EP, et al. Circulating tumor cells in patients with breast cancer dormancy. Clin Cancer Res. 2004;10:8152–62.CrossRefPubMed
23.
Zurück zum Zitat Engel J, Eckel R, Kerr J, et al. The process of metastasisation for breast cancer. Eur J Cancer. 2003;39:1794–806.CrossRefPubMed Engel J, Eckel R, Kerr J, et al. The process of metastasisation for breast cancer. Eur J Cancer. 2003;39:1794–806.CrossRefPubMed
24.
Zurück zum Zitat Husemann Y, Geigl JB. Schubert F, et al. Systemic spread is an early step in breast cancer. Cancer Cell. 2008;13:58–68.CrossRefPubMed Husemann Y, Geigl JB. Schubert F, et al. Systemic spread is an early step in breast cancer. Cancer Cell. 2008;13:58–68.CrossRefPubMed
25.
Zurück zum Zitat Wicha MS, Liu S, Dontu G. Cancer stem cells: an old idea—a paradigm shift. Cancer Res. 2006;66:1883–90.CrossRefPubMed Wicha MS, Liu S, Dontu G. Cancer stem cells: an old idea—a paradigm shift. Cancer Res. 2006;66:1883–90.CrossRefPubMed
26.
Zurück zum Zitat Xenidis N, Perraki M, Kafousi M, et al. Predictive and prognostic value of peripheral blood cytokeratin-19 mRNA-positive cells detected by real-time polymerase chain reaction in node-negative breast cancer patients. J Clin Oncol. 2006;24:3756–62.CrossRefPubMed Xenidis N, Perraki M, Kafousi M, et al. Predictive and prognostic value of peripheral blood cytokeratin-19 mRNA-positive cells detected by real-time polymerase chain reaction in node-negative breast cancer patients. J Clin Oncol. 2006;24:3756–62.CrossRefPubMed
27.
Zurück zum Zitat Ignatiadis M, Xenidis N, Perraki M, et al. Different prognostic value of cytokeratin-19 mRNA positive circulating tumor cells according to estrogen receptor and HER2 status in early-stage breast cancer. J Clin Oncol. 2007;25:5194–202.CrossRefPubMed Ignatiadis M, Xenidis N, Perraki M, et al. Different prognostic value of cytokeratin-19 mRNA positive circulating tumor cells according to estrogen receptor and HER2 status in early-stage breast cancer. J Clin Oncol. 2007;25:5194–202.CrossRefPubMed
28.
Zurück zum Zitat Xenidis N, Ignatiadis M, Apostolaki S, et al. Cytokeratin-19 mRNA-positive circulating tumor cells after adjuvant chemotherapy in patients with early breast cancer. J Clin Oncol. 2009;27:2177–84.CrossRefPubMed Xenidis N, Ignatiadis M, Apostolaki S, et al. Cytokeratin-19 mRNA-positive circulating tumor cells after adjuvant chemotherapy in patients with early breast cancer. J Clin Oncol. 2009;27:2177–84.CrossRefPubMed
29.
Zurück zum Zitat Rack B, Schindlbeck C, Schneeweiss A, et al. Prognostic relevance of circulating tumor cells (CTCs) in peripheral blood of breast cancer patients before and after adjuvant chemotherapy: the German SUCCESS-Trial (abstract 503). J Clin Oncol. 2008;26(Suppl). Rack B, Schindlbeck C, Schneeweiss A, et al. Prognostic relevance of circulating tumor cells (CTCs) in peripheral blood of breast cancer patients before and after adjuvant chemotherapy: the German SUCCESS-Trial (abstract 503). J Clin Oncol. 2008;26(Suppl).
30.
Zurück zum Zitat Riethdorf S, Fritsche H, Mueller V, et al. Detection of circulating tumor cells in peripheral blood of patients with metastatic breast cancer: a validation study of the CellSearch system. Clin Cancer Res. 2007;13:920–8.CrossRefPubMed Riethdorf S, Fritsche H, Mueller V, et al. Detection of circulating tumor cells in peripheral blood of patients with metastatic breast cancer: a validation study of the CellSearch system. Clin Cancer Res. 2007;13:920–8.CrossRefPubMed
Metadaten
Titel
Changes in Circulating Tumor Cell Detection in Patients with Localized Breast Cancer Before and After Surgery
verfasst von
Maria T. Sandri, MD
Laura Zorzino, DSc
Maria C. Cassatella, DSc
Fabio Bassi, MD
Alberto Luini, MD
Chiara Casadio, MD
Edoardo Botteri, PhD
Nicole Rotmensz, PhD
Laura Adamoli, PhD
Franco Nolè, MD
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 6/2010
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-0918-2

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