title: Circulating tumor cells in breast cancer beyond the genotype of primary tumor for tailored therapy.
abstract: Although TNM staging based on tumor, node lymph status and metastasis status-is the most widely used method in the clinic to classify breast cancer (BC) and assess prognosis, it offers limited information for different BC subgroups. Circulating tumor cells (CTCs) are regarded as minimal residual disease and are proven to have a strong relationship with BC. Detection of ≥5 CTCs per 7.5 mL in peripheral blood predicts poor prognosis in metastatic BC irrespective of other clinical parameters, whereas, in early-stage BC, detection of CK19(+) CTCs are also associated with poor prognosis. Increasing data and clinical trials show that CTCs can improve prognostic accuracy and help tailor treatment for patients with BC. However, heterogeneous CTCs in the process of an epithelial-mesenchymal transition (EMT) in BC makes it a challenge to detect these rare cells. Moreover, the genotypic and phenotypic features of CTCs are different from primary BC tumors. Molecular analysis of CTCs in BC may benefit patients by identifying those amenable to tailored therapy. We propose that CTCs should be used alongside the TNM staging system and the genotype of primary tumor to guide tailored BC diagnosis and treatment.
authors.affiliation: Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.|Department of Epidemiology and Biostatistics, Ministry of Education (MOE) Key Laboratory of Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Chuanli
authors.initials: C
authors.lastname: Ren
authors.affiliation: Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Chongxu
authors.initials: C
authors.lastname: Han
authors.affiliation: Breast Oncology Surgery, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Deyuan
authors.initials: D
authors.lastname: Fu
authors.affiliation: Clinical Medical Testing Laboratory, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Daxin
authors.initials: D
authors.lastname: Wang
authors.affiliation: Geriatric Medicine Department, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Oncology Department, Northern Jiangsu People's Hospital and Clinical Medical College of Yangzhou University, Yangzhou, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Physical Chemistry, Yangzhou University, Yangzhou, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Shen
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000097:blood / Q000235:genetics / Q000473:pathology*; D005260:Female; D005838:Genotype; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*
keywords: TNM staging; breast cancer; circulating tumor cells (CTCs)