title: Usefulness of CTC and DTC-BM Detection for Adjuvant Therapy Effects and Prognosis Prediction in Early Breast Carcinoma: Results of 8-11 Years of Follow-up Evaluation.
abstract: BACKGROUND
  Circulating tumor cells (CTCs) reportedly have been detected in the peripheral blood of more than 50% of breast carcinoma cases with distant metastases. Moreover, the survival period is shorter for patients who had more than five CTCs after a single chemotherapy treatment. However, a few data show the relationships between CTCs and expressions of disseminated tumor cells in the bone marrow (DTCs-BM), including treatment effects and prognoses in early breast carcinomas.
  
  
  METHODS
  In this study, CTCs and DTC-BMs were measured by the CellSearch System for 20 patients with stages 1-3 carcinomas, who were followed for 8-11 years.
  
  
  RESULTS
  CTCs in 2 (10%) of 20 breast carcinomas, more than 1 CTC was detected before adjuvant therapy, and both cases showed a decrease to 0 after chemotherapy. DTC-BMs in 19 (95%) of the 20 primary cases, more than 1 cell was found in the BM. After adjuvant therapy, 16 cases showed a decrease to 0-10 cells, 2 cases to 11-20 cells, and 2 cases to more than 21 cells. Six patients experienced recurrence. One of the two CTC-positive cases (>21 cells) had bone and liver metastasis within 11 months. Among the DTC-BM cases, only 1 (16.7%) of the 6 primary patients with 11-20 cells had recurrence, whereas 4 (80%) of the 5 patients with more than 21 cells had recurrence 3-6 years later.
  
  
  CONCLUSIONS
  Detection of DTC-BMs is useful for observing adjuvant therapy effects and for predicting relatively late-phase metastasis. The cluster status of CTCs suggests early relapsing.
authors.affiliation: Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan. takeyama@jikei.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeyama
authors.affiliation: Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shimada
authors.affiliation: Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kinoshita
authors.affiliation: Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Uchida
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology*; D001859:Bone Neoplasms / Q000556:secondary*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D002452:Cell Count; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000187:drug effects; D011379:Prognosis; D013629:Tamoxifen / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D047072:Aromatase Inhibitors; D013629:Tamoxifen; D007987:Gonadotropin-Releasing Hormone; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil