title: Measurement of circulating cell-free DNA levels by a simple fluorescent test in patients with breast cancer.
abstract: OBJECTIVE
  To evaluate circulating cell-free DNA (CFD) measured by a simple fluorescent assay as a biomarker of breast cancer.
  
  
  METHODS
  We enrolled 38 patients with breast cancer before surgery, two patients with noncancerous breast lesions, nine patients after surgery, 16 healthy participants, and 29 control women admitted to the hospital emergency ward and released without hospitalization. CFD levels were measured by a direct fluorescence assay.
  
  
  RESULTS
  Presurgery patients with cancer had elevated CFD levels (1,010 ± 642 ng/mL), which were higher than those measured in the healthy control group (395 ± 248 ng/mL, P < .001), the noncancer breast lesion group (386 ± 40 ng/mL), the nonhospitalized control group (492 ± 193 ng/mL, P < .001), and the postsurgery cancer group (398 ± 162 ng/mL, P < .01). The area under the receiver operating characteristic curve of the presurgery vs healthy patient group was 0.83. CFD levels correlated with tumor size (P = .03, ρ = 0.36), nodal involvement (P = .0003, ρ = 0.56), and TNM stage (P = .0002, ρ = 0.56). All patients with axillary node involvement had a CFD value greater than 600 ng/mL.
  
  
  CONCLUSIONS
  CFD measured using a simple fluorometric assay has shown good correlation to stage and enhanced sensitivity to locally advanced disease. A large prospective study is warranted to evaluate if inclusion of this method as a decisive marker before mammography is advantageous.
authors.affiliation: From the Department of General Surgery, Soroka University Medical Center, Beer Sheva, Israel;
authors.forename: Ravit
authors.initials: R
authors.lastname: Agassi
authors.affiliation: From the Department of General Surgery, Soroka University Medical Center, Beer Sheva, Israel;
authors.forename: David
authors.initials: D
authors.lastname: Czeiger
authors.affiliation: From the Department of General Surgery, Soroka University Medical Center, Beer Sheva, Israel;
authors.forename: Gad
authors.initials: G
authors.lastname: Shaked
authors.affiliation: Lung Clinic, Soroka University Medical Center, Beer Sheva, Israel;
authors.forename: Avital
authors.initials: A
authors.lastname: Avriel
authors.affiliation: Department of Clinical Biochemistry and Pharmacology, Soroka University Medical Center, and Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer Sheva, Israel; Department of Psychiatry, University of Michigan, Ann Arbor; and.
authors.forename: Jony
authors.initials: J
authors.lastname: Sheynin
authors.affiliation: Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Lavrenkov
authors.affiliation: Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ariad
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor; and amosd@bgu.ac.il.
authors.forename: Amos
authors.initials: A
authors.lastname: Douvdevani
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002474:Cell-Free System; D004247:DNA / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests
chemical_list: D014408:Biomarkers, Tumor; D004247:DNA
keywords: Biomarker; Breast cancer; CA 15-3; Circulating cell-free DNA (CFD); Lymph node involvement