scholarly journals Circulating tumour cell enumeration does not correlate with Miller–Payne grade in a cohort of breast cancer patients undergoing neoadjuvant chemotherapy

2020 ◽  
Vol 181 (3) ◽  
pp. 571-580 ◽  
Author(s):  
Sharon A. O’Toole ◽  
Cathy Spillane ◽  
Yanmei Huang ◽  
Marie C. Fitzgerald ◽  
Brendan Ffrench ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Complete Response ◽  
Pathological Response ◽  
Grading System ◽  
Breast Cancer Patients ◽  
Pre Treatment

Abstract Purpose The association between pathological complete response (pCR) in patients receiving neoadjuvant chemotherapy (NAC) for breast cancer and Circulating Tumour Cells (CTCs) is not clear. The aim of this study was to assess whether CTC enumeration could be used to predict pathological response to NAC in breast cancer as measured by the Miller–Payne grading system. Methods Twenty-six patients were recruited, and blood samples were taken pre- and post-NAC. CTCs were isolated using the ScreenCell device and stained using a modified Giemsa stain. CTCs were enumerated by 2 pathologists and classified as single CTCs, doublets, clusters/microemboli and correlated with the pathological response as measured by the Miller–Payne grading system. χ2 or ANOVA was performed in SPSS 24.0 statistics software for associations. Results 89% of patients had invasive ductal carcinoma (IDC) and 11% invasive lobular carcinoma (ILC). At baseline 85% of patients had CTCs present, median 7 (0–161) CTCs per 3 ml of whole blood. Post-chemotherapy, 58% had an increase in CTCs. This did not correlate with the Miller–Payne grade of response. No significant association was identified between the number of CTCs and clinical characteristics; however, we did observe a correlation between pre-treatment CTC counts and body mass index, p < 0.05. Conclusions Patients with a complete response to NAC still had CTCs present, suggesting enumeration is not sufficient to aid surgery stratification. Additional characterisation and larger studies are needed to further characterise CTCs isolated pre- and post-chemotherapy. Long-term follow-up of these patients will determine the significance of CTCs in NAC breast cancer patients.

scholarly journals Circulating tumour cell enumeration does not correlate with Miller-Payne grade in a cohort of breast cancer patients undergoing neoadjuvant chemotherapy

2019 ◽  
Author(s):  
Sharon O'Toole ◽  
Cathy Spillane ◽  
Yanmei Huang ◽  
Marie Fitzgerald ◽  
Brendan Ffrench ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Complete Response ◽  
Pathological Response ◽  
Breast Cancer Patients ◽  
Response To Chemotherapy ◽  
Pre Treatment

Abstract Background: Detection and enumeration of Circulating Tumour Cells (CTCs) has been evaluated in many cancers such as breast cancer. However, the full prognostic and predictive power of CTCs for cancer cannot currently be harnessed, and the association between pathological complete response in patients receiving neoadjuvant chemotherapy for breast cancer and CTCs is still not clear. The aim of this study was to assess if CTCs could be used to predict pathological response to neoadjuvant chemotherapy in breast cancer patients. Methods: 26 patients were recruited, and blood samples taken pre- and post-neoadjuvant chemotherapy. CTCs were isolated using the ScreenCell device and stained using a modified Giemsa stain. CTCs were enumerated by 2 pathologists and classified as single CTCs, doublets clusters/microemboli. Counts were then correlated to the pathological response as measured by the Miller-Payne grading system. The associations between CTCs and clusters and pathological variables were evaluated with χ2 or ANOVA tests performed in the SPSS 24.0 statistics software. Results: 89% of the patients had invasive ductal carcinoma and 11% invasive lobular carcinoma. At baseline 85% of patients had CTCs present and only 4 patients were CTC negative. Median baseline CTC count was 7 (0-161) CTCs per 3mls of whole blood. Post chemotherapy, 58% of the patients had an increase in CTCs. This change in CTC count did not correlate with the Miller Payne grade of response to chemotherapy. No significant association was identified between the number of CTCs and clinical characteristics, including patient age, receptor status, tumour grade, disease type, lymph node metastasis, lymphovascular space invasion, radiological response or clinical or pathological stage. However, we did observe a correlation between pre-treatment CTC counts and body mass index, p<0.05. Conclusions: There was no correlation between the pre- and post-chemotherapy total number of CTCs/clusters and the Miller Payne grade. It is not enough to evaluate pathological response for neoadjuvant chemotherapy for breast cancer patients utilising CTCs identified by Giemsa staining alone. Additional characterisation is needed to further characterise CTCs isolated pre- and post-chemotherapy. Long-term follow-up of these patients will determine the significance of CTCs in breast cancer patients undergoing neoadjuvant chemotherapy.

scholarly journals Plasma Fibrinogen Acts as a Predictive Factor for Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Retrospective Study of 1035 Chinese Breast Cancer Patients

2020 ◽  
Author(s):  
Yihua Wang ◽  
Yu Wang ◽  
Rui Chen ◽  
Zhenrong Tang ◽  
Yang Peng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Factor ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Plasma Fibrinogen ◽  
Multivariate Logistic Regression Model ◽  
Breast Cancer Patients ◽  
Pre Treatment

Abstract Background: The aim of this study was to evaluate the relationship between pre-treatment plasma fibrinogen (Fib) level and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and to assess the role of plasma Fib as a predictive factor.Methods: Data from 1035 consecutive patients with invasive breast cancer who received NAC and subsequent surgery were retrospectively analysed. Both univariate and multivariate analyses were performed to identify clinicopathological factors associated with pCR to NAC.Results: The median value of Fib, rather than other plasma coagulation parameters, was significantly increased in non-pCR patients compared with pCR patients (P = 0.008). Based on the cut-off value estimated by the ROC curve analysis, samples were divided into low or high Fib groups (Fib < 3.145 g/L or ≥ 3.145 g/L). Low Fib status was significantly associated with premenopausal or perimenopausal status (P < 0.001), ≤ 5cm tumour size (P = 0.001), positive hormone receptor status (P = 0.003) and > 14% Ki67 index (P = 0.028). Adjusted for other clinicopathologic factors in the multivariate logistic regression model, low Fib status was strongly associated with pCR to NAC (OR = 2.365, 95% CI = 1.354-4.133, P = 0.002).Conclusions: This study demonstrates that low pre-treatment plasma Fib (Fib < 3.145 g/L) is an independent predictive factor for pCR to NAC in breast cancer patients.

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