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Portrait of Daniel Förnvik. Photo

Daniel Förnvik

Associate professor

Portrait of Daniel Förnvik. Photo

Detection of circulating tumor cells and circulating tumor DNA before and after mammographic breast compression in a cohort of breast cancer patients scheduled for neoadjuvant treatment

Author

  • Daniel Förnvik
  • Kristina Aaltonen
  • Yilun Chen
  • Anthony George
  • Christian Brueffer
  • Robert Rigo
  • Niklas Loman
  • Lao Saal
  • Lisa Rydén

Summary, in English

Purpose
It is not known if mammographic breast compression of a primary tumor causes shedding of tumor cells into the circulatory system. Little is known about how the detection of circulating biomarkers such as circulating tumor cells (CTCs) or circulating tumor DNA (ctDNA) is affected by breast compression intervention.

Methods
CTCs and ctDNA were analyzed in blood samples collected before and after breast compression in 31 patients with primary breast cancer scheduled for neoadjuvant therapy. All patients had a central venous access to allow administration of intravenous neoadjuvant chemotherapy, which enabled blood collection from superior vena cava, draining the breasts, in addition to sampling from a peripheral vein.

Results
CTC and ctDNA positivity was seen in 26% and 65% of the patients, respectively. There was a significant increase of ctDNA after breast compression in central blood (p = 0.01), not observed in peripheral testing. No increase related with breast compression was observed for CTC. ctDNA positivity was associated with older age (p = 0.05), and ctDNA increase after breast compression was associated with high Ki67 proliferating tumors (p = 0.04). CTCs were more abundant in central compared to peripheral blood samples (p = 0.04).

Conclusions
There was no significant release of CTCs after mammographic breast compression but more CTCs were present in central compared to peripheral blood. No significant difference between central and peripheral levels of ctDNA was observed. The small average increase in ctDNA after breast compression is unlikely to be clinically relevant. The results give support for mammography as a safe procedure from the point of view of CTC and ctDNA shedding to the blood circulation. The results may have implications for the standardization of sampling procedures for circulating tumor markers.

Department/s

  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Medical Radiation Physics, Malmö
  • Division of Translational Cancer Research
  • Molecular Pediatric Oncology
  • Translational Oncogenomics
  • Breastcancer-genetics
  • The Liquid Biopsy and Tumor Progression in Breast Cancer
  • Surgery (Lund)

Publishing year

2019-06-24

Language

English

Pages

447-455

Publication/Series

Breast Cancer Research and Treatment

Volume

177

Issue

2

Document type

Journal article

Publisher

Springer

Topic

  • Cancer and Oncology
  • Radiology and Medical Imaging

Keywords

  • cancer
  • breast cancer
  • liquid biopsy
  • Circulating tumor cells (CTCs)
  • circulating tumor DNA

Status

Published

Project

  • Sweden Cancerome Analysis Network - Breast (SCAN-B): a large-scale multicenter infrastructure towards implementation of breast cancer genomic analyses in the clinical routine
  • Translational development and clinical applications of circulating tumor DNA for patient stratification, therapy guidance, and disease monitoring

Research group

  • Medical Radiation Physics, Malmö
  • Molecular Pediatric Oncology
  • Translational Oncogenomics
  • The Liquid Biopsy and Tumor Progression in Breast Cancer

ISBN/ISSN/Other

  • ISSN: 1573-7217