Circulating and Disseminated Tumor Cells in the Management of Breast Cancer

• Published in: American journal of clinical pathology Vol. 132; no. 2; pp. 237 - 245
• Main Authors: ROSS, Jeffrey S, SLODKOWSKA, Elzbieta A
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.08.2009
• Subjects: Biological and medical sciences; Breast Neoplasms - blood; Breast Neoplasms - pathology; Early Detection of Cancer; Female; Gynecology. Andrology. Obstetrics; Hematologic Tests - methods; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammary gland diseases; Medical sciences; Neoplastic Cells, Circulating; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Tumors; Breast disease; erbB2 Gene; Breast cancer; Malignant tumor; Human Epidermal growth factor Receptor 2; Mammary gland diseases; Anatomic pathology; Clinical management; C-Onc gene; Disseminated tumor cells; Disseminated; Lapatinib; Circulating tumor cells; HER2; Tumor cell; Protooncogene; Trastuzumab; Cancer
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/AJCPJI7DEOLKCS6F

Despite the advances in early detection and treatment of cancer, patients continue to die of the disease even when they seek care at an early stage. For patients with breast cancer, it is now possible to detect circulating tumor cells (CTCs) in the bloodstream and disseminated tumor cells (DTCs) in the bone marrow by using immunocytochemical and molecular methods. CTCs and DTCs have been found to share similar genotypic and phenotypic characteristics with so-called breast cancer stem cells, a finding that could potentially explain the eventual relapse of disease in a patient previously considered to have been cured by primary therapy. In some studies, the presence of CTCs or DTCs at the time of diagnosis of breast cancer is an independent adverse prognostic variable. However, before CTC/DTC testing can achieve standard-of-care status, there must be improvement in the sensitivity, precision, and reproducibility of the detection methods.