title: Detection of carcinoma cells in the blood of breast cancer patients.
abstract: BACKGROUND
  Breast cancers shed cancer cells into the blood soon after they become invasive. We developed an assay for removing these circulating cancer cells. In this study, we wanted to determine the percentage of early stage and metastatic patients with circulating breast cancer cells.
  
  
  METHODS
  Twenty milliliters of blood were drawn from patients with breast cancer. Epithelial cells were removed by immunomagnetic selection and analyzed by flow cytometry, cytomorphology, and immunocystochemistry.
  
  
  RESULTS
  Early stage patients averaged 16 epithelial cells per 20 cc blood whereas metastatic patients averaged 122 tumor cells. Cytomorphology and immunostains confirmed that these were cancer cells. Control blood samples had 1.7 squamous epithelial cells per 20 cc blood.
  
  
  CONCLUSIONS
  This assay can identify and characterize circulating breast cancer cells. Metastatic patients had more circulating cells than early stage patients. This assay could screen high-risk patients, determine the need for and monitor response to adjuvant therapy, and detect early recurrence of breast cancer.
authors.affiliation: General Surgery Department, St. Paul Medical Center, Dallas, Texas, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Beitsch
authors.forename: E
authors.initials: E
authors.lastname: Clifford
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D018189:Immunomagnetic Separation / Q000379:methods; D008207:Lymphatic Metastasis; D009360:Neoplastic Cells, Circulating; D012680:Sensitivity and Specificity