Abstract Cancer cells heterogeneity presents a major roadblock in clinical diagnostics and therapy. Investigations of tumor cell heterogeneity using single-cell analytical techniques have revealed not only the presence of multiple clonal subpopulations but also phenotypic variability among genetically identical cells. This heterogeneity plays a critical role in therapeutics, as population extrema, rather than cells near the ensemble mean, can dominate pathogenesis as well as drug resistance. To characterize single cell heterogeneity, multiple techniques quantifying single-cell gene expression have been developed. However, there's a lack of experimental techniques to measure how cellular decision-making processes underlying population variability derive from extracellular biochemical input signals, such as peptide growth factors, which cannot be measured at the single-cell level. Here, to digitally count growth factors in single cells, we develop a novel method combining fluorescent quantum dots and calibrated three-dimensional deconvolution microscopy (QDC-3DM). Using quantum dots with near-infrared emission to overcome intrinsic cellular autofluorescence, we were able to detect and accurately count individual quantum dots conjugated to epidermal growth factor (EGF) using their fluorescent intensities. Analyzing triple-negative breast cancer cells (MDA-MB-231) with QDC-3DM, we observed that single-cell heterogeneity in growth factor stimulation led to heterogeneity in receptor activation. When treating cells with increasing concentration of phamarcological inhibitor blocking receptor activation, we observed a proportional increase in receptor activation heterogeneity. Together, our results indicate that external stimulation contributes to signaling variation and drug response variation at the single-cell level. We anticipate that QDC-3DM can be applied to any peptidic ligands to study how extracellular signaling stimulation contributes to phenotypic variability to provide new insight into cancer cell heterogeneity that plays a critical role in therapeutic resistance. Citation Format: Phuong Le, Brian C. Baculis, Hee Jung Chung, Kristpher Kilian, Andrew M. Smith. Investigating how extracellular signals contribute to single cancer cell heterogeneity using near-infrared quantum dots [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr LB-330.