Circulating tumor cells in patients with breast cancer dormancy.
OBJECTIVE
The purpose of this study was to test the hypothesis that circulating tumor cells (CTCs) are present in patients many years after mastectomy without evidence of disease and that these CTCs are shed from persisting tumor in patients with breast cancer dormancy.


METHODS
We searched for CTCs in 36 dormancy candidate patients and 26 age-matched controls using stringent criteria for cytomorphology, immunophenotype, and aneusomy.


RESULTS
Thirteen of 36 dormancy candidates, 7 to 22 years after mastectomy and without evidence of clinical disease, had CTCs, usually on more than one occasion. Only 1 of 26 controls had a possible CTC (no aneusomy). The statistical difference of these two distributions was significant (exact P = 0.0043). The CTCs in patients whose primary breast cancer was just removed had a half-life measured in 1 to 2.4 hours.


CONCLUSIONS
The CTCs that are dying must be replenished every few hours by replicating tumor cells somewhere in the tissues. Hence, there appears to be a balance between tumor replication and cell death for as long as 22 years in dormancy candidates. We conclude that this is one mechanism underlying tumor dormancy.
Meng
Songdong
S
Cancer Immunobiology Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8576, USA.
Tripathy
Debasish
D
Frenkel
Eugene P
EP
Shete
Sanjay
S
Naftalis
Elizabeth Z
EZ
Huth
James F
JF
Beitsch
Peter D
PD
Leitch
Marilyn
M
Hoover
Susan
S
Euhus
David
D
Haley
Barbara
B
Morrison
Larry
L
Fleming
Timothy P
TP
Herlyn
Dorothee
D
Terstappen
Leon W M M
LW
Fehm
Tanja
T
Tucker
Thomas F
TF
Lane
Nancy
N
Wang
Jianqiang
J
Uhr
Jonathan W
JW
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D015409:Mastectomy, Radical; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*
D014408:Biomarkers, Tumor