Abstract
Background:The enumeration of circulating tumour cells (CTC) has prognostic significance in patients with metastatic breast cancer (MBC) and monitoring of CTC levels over time has considerable potential to guide treatment decisions. However, little is known on CTC kinetics in the human bloodstream.Methods:In this study, we compared the number of CTC in both 7.5 ml central venous blood (CVB) and 7.5 ml peripheral venous blood (PVB) from 30 patients with MBC starting with a new line of chemotherapy.Results:The number of CTC was found to be significantly higher in CVB (median: 43.5; range: 0–4036) than in PVB (median: 33; range: 0–4013) (P=0.001). When analysing samples pairwise, CTC counts were found to be significantly higher in CVB than in PVB in 12 out of 26 patients with detectable CTC. In contrast, only 2 out of 26 patients had higher CTC counts in PVB as compared with CVB, whereas in 12 remaining patients no significant difference was seen. The pattern of CTC distribution was independent of the sites of metastatic involvement.Conclusion:A substantial difference in the number of CTC was observed between CVB and PVB of patients with MBC. Registration of the site of blood collection is warranted in studies evaluating the role of CTC assessment in these patients.
Highlights
The enumeration of circulating tumour cells (CTC) has prognostic significance in patients with metastatic breast cancer (MBC) and monitoring of CTC levels over time has considerable potential to guide treatment decisions
We compared the number of CTC, as assessed by the CellSearch System, in blood samples obtained from different sites throughout the circulation in 30 patients with MBC
We observed significantly higher numbers of CTC in central venous blood (CVB) than in peripheral venous blood (PVB) in 46% of the patients with detectable CTC
Summary
The enumeration of circulating tumour cells (CTC) has prognostic significance in patients with metastatic breast cancer (MBC) and monitoring of CTC levels over time has considerable potential to guide treatment decisions. METHODS: In this study, we compared the number of CTC in both 7.5 ml central venous blood (CVB) and 7.5 ml peripheral venous blood (PVB) from 30 patients with MBC starting with a new line of chemotherapy. RESULTS: The number of CTC was found to be significantly higher in CVB (median: 43.5; range: 0 – 4036) than in PVB (median: 33; range: 0 – 4013) (P 1⁄4 0.001). CTC counts were found to be significantly higher in CVB than in PVB in 12 out of 26 patients with detectable CTC. Only 2 out of 26 patients had higher CTC counts in PVB as compared with CVB, whereas in 12 remaining patients no significant difference was seen. CONCLUSION: A substantial difference in the number of CTC was observed between CVB and PVB of patients with MBC. British Journal of Cancer (2011) 104, 1472 – 1477. doi:10.1038/bjc.2011.122 www.bjcancer.com Published online 5 April 2011 & 2011 Cancer Research UK
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