Circulating Tumor Cells and Recurrence After Primary Systemic Therapy in Stage III Inflammatory Breast Cancer

J Natl Cancer Inst. 2015 Sep 14;107(11):djv250. doi: 10.1093/jnci/djv250. Print 2015 Nov.

Abstract

Inflammatory breast cancer (IBC) is rare and aggressive, with poor survival. While circulating tumor cells (CTCs) predict outcome in non-IBC patients, little data exists regarding their prognostic significance in IBC. This prospective study analyzed blood samples for CTCs from 63 stage III IBC patients to determine if CTCs present after primary systemic chemotherapy predicted relapse. CTC identification was not associated with tumor characteristics, lymph node positivity, or complete pathologic response to systemic therapy. At mean follow-up of 38 months, multivariable analysis demonstrated that detection of one or more CTCs predicted shortened relapse-free (log-rank P = 0.005, hazard ratio [HR] = 4.22, 95% confidence interval [CI] = 1.67 to 10.67, Cox P = 0.002) but not overall survival (log-rank P = 0.54, HR = 1.53, 95% CI = 0.41 to 5.79, Cox P = 0.53). All statistical tests were two-sided. In this study, CTCs after primary chemotherapy identified IBC patients at high risk for relapse.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Humans
  • Inflammatory Breast Neoplasms / diagnosis*
  • Inflammatory Breast Neoplasms / pathology
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Staging
  • Neoplastic Cells, Circulating*
  • Odds Ratio
  • Proportional Hazards Models
  • Prospective Studies