Detection of circulating tumour cells before and following adjuvant chemotherapy and long-term prognosis of early breast cancer

BackgroundThe detection of circulating tumour cells (CTC) is prognostic for disease recurrence in early breast cancer (BC). This study aims to investigate whether this prognostic effect persists or varies over time.MethodsThe study population consisted of prospectively included stage I–III BC patients. The presence ofCK19mRNA-positive CTC in the peripheral blood was evaluated before and after adjuvant chemotherapy, using a real-time RT–PCR assay. Longitudinal samples were collected for a subset of patients.ResultsBaseline CTC data were available from 1220 patients, while 1132 had both pre- and post-therapy data. After a median follow-up of 134.1 months, CTC positivity at baseline was associated with shorter overall survival (OS; HRadj = 1.72, 95% CI 1.34–2.21,p p = 0.045) was observed. CTC positivity predicted early (within 5 years; HRadj = 1.76, 95%CI 1.33–2.32,p adj = 1.10, 95% CI 0.79–1.53,p = 0.577). Following adjuvant chemotherapy, more patients converted from CTC-positive to CTC-negative than vice versa (p p ConclusionCTC detection pre- and post-adjuvant chemotherapy is prognostic for early relapse, supporting investigations for novel adjuvant therapeutic approaches.