Utility of Circulating Tumor Cells for Detection of Early-Stage Luminal A Breast Cancer

Am J Med Sci. 2020 Nov;360(5):543-551. doi: 10.1016/j.amjms.2020.01.020. Epub 2020 Feb 7.

Abstract

Background: Patients with early-stage luminal A breast cancer (LABC) have better prognoses. However, follow-up examinations are frequent and remain complex. The present study examined whether circulating tumor cell (CTC) detection could be used as an earlier and more reproducible indicator of disease status among patients with early-stage LABC, and given China's healthcare resource challenges, whether it could periodically replace follow-up routine imaging.

Methods: A total of 135 postoperative Chinese patients with early-stage LABC were randomly assigned to a CTC group (68 patients underwent alternating assessments using CTC detection and routine re-examination) or control group (67 patients underwent only routine re-examination). The prognosis and patient-covered costs of the various assessments were calculated for the 2 groups.

Results: No patients had normal CTCs and simultaneous abnormal imaging findings. There were no differences in overall survival, disease-free survival and total patient-covered cost of follow-up between the 2 groups (all P > 0.05). However, there was a significant difference in the average patient-covered cost (P < 0.001). Furthermore, significant intergroup differences were observed in the total and average hospitalization times (P < 0.05).

Conclusions: Among Chinese patients with low-risk LABC, CTC detection was highly reliable and relatively low cost. Therefore, CTC detection may be used to reduce the number of routine imaging follow-ups.

Keywords: Breast cancer; Circulating tumor cells; Follow-up; Luminal A; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood*
  • Breast Neoplasms / blood*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / mortality
  • China / epidemiology
  • Cohort Studies
  • Early Detection of Cancer / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neoplasm Staging / methods
  • Neoplastic Cells, Circulating / metabolism*
  • Neoplastic Cells, Circulating / pathology
  • Prospective Studies
  • Random Allocation
  • Survival Rate / trends

Substances

  • Biomarkers, Tumor