Circulating Tumor Cells in Early-Stage Breast Cancer

Abstract

Disseminated tumor cells (DTC) are routinely detected in bone marrow (BM) in 30–40 % of primary breast cancer patients. Positive BM status at the time of diagnosis as well as DTC persistence after therapy are strong independent prognostic factors. Since repeated BM aspirations are not well tolerated, detection of single tumor cells in peripheral blood (circulating tumor cells; CTC) have become of interest in recent years. CTC are found in 10–80 % breast cancer patients. Variability can be explained by stage of the disease and detection method. Emerging data have shown CTC to be of prognostic relevance for both, patients with primary and metastatic disease. The assessment of CTC in blood may become an important biomarker for prognostication and therapy monitoring. Determination of their molecular characteristics will enable specific targeting of minimal residual as well as metastatic disease. This review summarizes recent research and future perspectives.

Zusammenfassung

Disseminierte Tumorzellen im Knochenmark können in 30–40 % aller Patientinnen mit primärem Mammakarzinom entdeckt werden. Der Nachweis von disseminierten Tumorzellen zum Zeitpunkt der Erstdiagnose, aber auch die Persistenz derselben unter einer Therapie sind ungünstige prognostische Faktoren. Die Praktikabilität von wiederholten Knochenmarkspunktionen unter einer Therapie ist jedoch zeit- und kostenintensiv und für die Patientin unangenehm. Deswegen bietet die Untersuchung von peripherem Blut deutliche Vorteile. Zirkulierende Tumorzellen können in 10–80 % aller Patientinnen entdeckt werden. Die Rate hängt von der Analysemethode und dem Stadium der Erkrankung ab. Es konnte bereits nachgewiesen werden, dass das Vorhandensein von Tumorzellen im peripheren Blut sowohl für Patientinnen mit Metastasen als auch für Patientinnen ohne Metastasen von prognostischer Bedeutung ist. Eine molekulare Charakterisierung der zirkulierenden Tumorzellen könnte weiterhelfen, spezifische Therapien zu entwicklen, die sich direkt gegen diese Tumorzellen richten und so helfen, diese zu eliminieren. Dieser Übersichtsartikel fasst die aktuelle Literatur zusammen und gibt eine Zukunftsperspektive zu dem Thema.

Key words

breast cancer - disseminated tumor cell - circulating tumor cell - prognosis - biomarkers

Schlüsselwörter

Brustkrebs - disseminierte Tumorzellen - zirkulierende Tumorzellen - Prognose - Biomarker

Footnote

^* equally contributed

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