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According to the results of a study presented at the European Cancer Conference (ECCO 14), measurement of circulating tumor cells in the blood of breast cancer patients may provide information about risk of cancer recurrence.

Treatment of breast cancer often involves local therapy, such as surgery and radiation, as well as systemic (whole-body) therapy such as chemotherapy, hormonal therapy, and targeted therapy.

Decisions about the need for systemic therapy, and about the most appropriate types of systemic therapy, depend on many factors, including tumor size, whether cancer has spread to nearby lymph nodes, hormone receptor status, and HER2 status.

Another factor that may eventually guide treatment decisions is the presence of circulating tumor cells in the blood. Circulating tumor cells have been linked with a worse prognosis in women with metastatic breast cancer, but less is known about the importance of circulating tumor cells in women with earlier-stage breast cancer.

To evaluate circulating tumor cells in women with node-positive and high-risk node-negative breast cancer, researchers conducted a study among 1,767 women. For 852 of these women, blood samples were available both before and after chemotherapy.

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  • Before treatment, 10% of the women were found to have more than one circulating tumor cell in their blood sample.
  • Of the patients who initially had evidence of circulating tumor cells, 90% were free of circulating tumor cells after completion of chemotherapy.
  • Of the patients who were initially free of circulating tumor cells, 93% remained free of circulating tumor cells.

The researchers hypothesize that the presence of circulating tumor cells after chemotherapy will be linked with a higher risk of cancer recurrence. Results about the link between circulating tumor cells and outcome of adjuvant therapy will be available in the future. If a link is demonstrated, a simple blood test may provide important information about a woman’s risk of breast cancer recurrence, and about the optimal approach to treatment.

Reference: Jueckstock J, Rack B, Thurner-Hermanns E et al. Detection of minimal residual disease (MRD) in peripheral blood of primary breast cancer patients – Translational research in the SUCCESS Study. Presented at ECCO-14 – The European Cancer Conference. Barcelona, Spain, September 23-27, 2007. Abstract O#2032.

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