Measuring Circulating Tumor Cells May Help Determine Recurrence Risk

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If you've been diagnosed with early breast cancer, a lot of your treatment plan is aimed at reducing the risk of the cancer coming back (recurrence). Chemotherapy, targeted therapy, radiation therapy, and hormonal therapy given before or after surgery are all used to lower your risk of recurrence.

Better ways to determine the risk of recurrence would allow doctors to create treatment plans tailored to each woman's individual recurrence risk. So if there were a test that told you and your doctor that your recurrence risk was very low, you might decide to skip chemotherapy after surgery. Right now, some breast cancer characteristics -- such as grade and stage -- offer a rough estimate of your recurrence risk, but it's not as precise as anyone would like.

A study offers hope that doctors eventually may be able to estimate anyone's risk of recurrence with more precision, allowing treatment to be tailored to individual risk. The researchers suspect that if circulating tumor cells (CTCs) are in the blood before and after chemotherapy given after surgery, the risk of recurrence is high. If CTCs are not in the blood before and after chemotherapy, the risk of recurrence is low. Still, this study doesn't prove that a CTC test would offer a more accurate estimate of recurrence risk.

There are three tests that look at the genetic make-up of the breast cancer and use that information to predict recurrence. Those tests are the Oncotype DX test, the MammaPrint test, and the Mammostrat test. The Oncotype DX and Mammostrat tests are used to develop recurrence scores for lymph node-negative, estrogen-receptor-positive, early-stage breast cancers. The MammaPrint test is used to develop recurrence scores for lymph node-negative, early-stage breast cancers. These tests are relatively new and have been tested on relatively small groups of women.

Each woman's breast cancer situation is different. In addition to cancer characteristics, recurrence tests may give you and your doctor one more piece of information that you can use to make treatment decisions. If you've been diagnosed with node-negative, early breast cancer, talk to your doctor to see if a recurrence test makes sense for you. And stay tuned to breastcancer.org for the latest updates on new tests that will help ensure the best treatment for YOU.

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