Number of Circulating Cancer Cells Associated with Survival in Advanced Breast Cancer

Cancer cells found circulating in the blood are a strong predictor of mortality among patients with metastatic breast cancer. Patients with large numbers of cancer cells found circulating in the blood may benefit from more aggressive or novel therapeutic approaches. These results were recently published in the Journal of Clinical Oncology.

Metastatic breast cancer refers to breast cancer that has spread to distant sites in the body. The majority of patients with metastatic breast cancer are not cured with standard therapies; however, treatment has evolved in such a way that women with this disease may be able to achieve long-term survival. Researchers continue to evaluate ways to identify patients who might benefit from additional or more aggressive therapies to improve survival, such as the presence of cancer cells found in circulating blood (circulating tumor cells).

Researchers from the MD Anderson Cancer Center recently conducted a study to review data further evaluating the predictive value of circulating tumor cells among women with metastatic breast cancer. This study included 185 women treated at MD Anderson between 2001 and 2007 with a median age of 49. Blood samples were tested for the presence of circulating tumor cells with a laboratory test called the Cell Search System.

The results indicated that 38% of women had 5 or more circulating tumor cells. Median overall survival was 28 months for patients with fewer than 5 circulating tumor cells, compared with only 15 months for patients with 5 or more circulating tumor cells. The number of circulating tumor cells remained a strong survival predictor even in the presence of other important variables, such as hormone receptor status, HER-2 status, sites of cancer spread, or a diagnosis of recurrent or new disease.

The researchers concluded that the number of circulating tumor cells appears to be a strong predictor of survival among women with metastatic breast cancer. Women with metastatic breast cancer may wish to speak with their physician regarding their individual risks and benefits of undergoing testing for circulating tumor cells.

Reference: Dawood S, Broglio K, Valero V, et al. Circulating tumor cells in meatstatic breast cancer. From prognostic stratification to modification of the staging system? Journal of Clinical Oncology 2008;113:2422-2430.

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