title: Circulating tumor cells before and during follow-up after breast cancer surgery.
abstract: The presence of circulating tumor cells (CTC) is an independent prognostic factor for progression-free and overall survival for patients with metastatic and newly diagnosed breast cancer. The present study was undertaken to explore whether the presence of CTC before and during follow-up after surgery is associated with recurrence free survival (RFS) and overall survival (OS). In a prospective single center study, CTC were enumerated with the CellSearch system in 30 ml of peripheral blood of 403 stage I-III patients before undergoing surgery for breast cancer (A) and if available 1 week after surgery (B), after adjuvant chemo- and/or radiotherapy or before start of long-term hormonal therapy (C), one (D), two (E) and three (F) years after surgery. Patients were stratified into unfavorable (CTC≥1) and favorable (CTC=0) prognostic groups. >1 CTC in 30 ml blood was detected in 75/403 (19%) at A, 66/367 (18%) at B, 40/263 (15%) at C, 30/235 (12%) at D, 18/144 (11%) at E and 11/83 (13%) at F. RFS and OS was significantly lower for unfavorable CTC as compared to favorable CTC before surgery (p=0.022 and p=0.006), after adjuvant therapy (p<0.001 and p=0.018) and one (p=0.006 and p=0.013) and two (p<0.001 and p=0.045) years after surgery, but not 1 week post-surgery. The presence of CTC in blood drawn pre and one and two years after surgery, but not post-surgery is associated with shorter RFS and OS for stage I-III breast cancer.
authors.affiliation: Medical Cell BioPhysics Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
authors.forename: Guus
authors.initials: G
authors.lastname: van Dalum
authors.affiliation: Medical Cell BioPhysics Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: van der Stam
authors.affiliation: Medical Cell BioPhysics Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
authors.forename: Arjan G J
authors.initials: AG
authors.lastname: Tibbe
authors.affiliation: Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Franken
authors.affiliation: Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Walter J B
authors.initials: WJ
authors.lastname: Mastboom
authors.affiliation: Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vermes
authors.affiliation: Department of Internal Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Marco R
authors.initials: MR
authors.lastname: de Groot
authors.affiliation: Medical Cell BioPhysics Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
authors.forename: Leon W M M
authors.initials: LW
authors.lastname: Terstappen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor