Prognostic Relevance of Circulating Tumor Cells in Molecular Subtypes of Breast Cancer

Abstract

Circulating tumor cells (CTCs) can be detected in the peripheral blood of breast cancer patients with early and metastatic disease. Recent data suggest that immune pathologic characteristics between the primary tumor, metastatic colonies and CTCs are discordant and that CTCs possess an independent phenotype that is associated with prognosis and treatment efficacy. Large scale gene expression analysis has provided the possibility to stratify breast cancer according to the gene expression fingerprint of primary tumor tissue into five intrinsic molecular subtypes which can be associated with different clinical outcome. As a consequence of the different prognostic power of primary tumorsʼ characteristics and CTCs several groups have started to investigate if CTCs might be disseminated differentially within these breast cancer subtypes. They determined the CTC number in immunohistochemical subtypes to validate if CTCs may provide differential and more specific prognostic information within each subtype. This review provides an overview of the outcome of some recently published data gathered from early and metastatic breast cancer.

Zusammenfassung

Zirkulierende Tumorzellen (CTC) können im Blut von Mammakarzinom-Patientinnen in der adjuvanten sowie metastatischen Situation detektiert werden. Bezüglich des Immunphänotyps können sich CTC sowohl von den Metastasen als auch vom Primärtumor unterscheiden. Moderne Genexpressionsanalyse lässt Mammakarzinome in 5 molekulare Subtypen mit unterschiedlichem biologischem und klinischem Verhalten unterteilen. Aufgrund der unterschiedlichen prognostischen Bedeutung zirkulierender Tumorzellen und der prädiktiven Faktoren beim Mammakarzinom wurde das Phänomen der Tumorzelldissemination innerhalb der verschiedenen Mammakarzinom-Subtypen bereits von vielen Gruppen analysiert. Die CTC-Anzahl wurde bei Tumoren mit unterschiedlicher Immunhistochemie bestimmt und auf ihre prognostische Aussagekraft in Abhängigkeit von der Biologie des Primärtumors hin untersucht. Dieser Review bietet einen Überblick über aktuelle Daten im adjuvanten und metastasierten Setting.

Key words

breast cancer - circulating tumor cell - molecular subtype - prognosis

Schlüsselwörter

Mammakarzinom - zirkulierende Tumorzellen - molekularer Subtyp - Prognose

• References

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