Researchers found that the more CTCs an early-stage breast cancer patient has, the higher the risk.

Researchers from the Women's Hospital at the University of Munich have discovered that the number of circulating tumor cells (CTCs) found in a patient with early-stage breast cancer may be able to predict the risk of cancer recurrence and death.

Brigitte Rack, M.D., study leader and head of the department of gynecological oncology at the Women's Hospital at the University of Munich, Germany, along with a team of researchers, believe that the risk of cancer recurrence and death increases within an early-stage breast cancer patient if they have CTCs present. The more CTCs they have, the higher the risk of cancer relapse and death, according to Phase III results of the SUCCESS trial.

"The CTCs might have been released from the primary tumor before these patients underwent surgery, and the expression of stem cell markers on disseminated tumor cells has been shown by several groups," said Rack.

Rack and her team chose to use CTCs as a gauge for relapse and death prediction in metastatic breast cancer patients because a CTC test has been approved by the Food and Drug Administration, and previous studies have shown the effectiveness of using CTCs this way.

To test the CTCs' ability to predict such circumstances, Rack and her team studied patients with early-stage breast cancer who already had surgery, but did not have chemotherapy treatment yet. Out of 180 patients, 114 experienced cancer relapse and 66 died. Rack noted that 21.5 percent of these patients had one or more CTCs before adjuvant treatment, and were "more frequently node-positive." Patients with one to four CTCs had an 88 percent heightened risk of early breast cancer relapse and a 91 percent increased risk of death. Those with five or more CTCs had a heightened risk of recurrence by 400 percent and a 300 percent increased risk of death.

Rack and her team said being CTC-positive was an important indicator for the chance of survival within these patients. 

"Our study suggests testing CTCs may prove to be important to help individualize therapy for early-stage breast cancer where no measurable tumor is present," said Rack. "Patients who seem to be at high risk due to CTC may benefit from additional treatment options, and those who don't have CTCs may be spared side effects of some treatments."

Rack and her team plan to start trials testing this theory in Europe and the United States soon, but have not specified an exact date. 

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