The EMPathy Breast Cancer Network (BCN) is a national collaboration including scientists, breast surgeons, medical oncologists and a consumer advocate investigating the role of circulating tumour cells (CTC) and epithelial mesenchymal plasticity in breast cancer recurrence.
Aim: To assay CTC from the blood and disseminated tumour cells (DTC) from the bone marrow in a prospective cohort of women with early stage breast cancer (EBC) at diagnosis and during follow-up.
Methods: Women with EBC treated at St Vincent’s Hospital Melbourne were recruited from Oct 10 - Jun 14. Bone marrow and blood were taken at diagnosis, with blood samples repeated at 3, 6, 12 and 24 months. CTCs and DTCs were isolated using in-house anti-EpCAM and anti-EGFR immunobeads in parallel and sequentially. Following RNA extraction a 43 gene assay panel was assessed by quantitative RT-PCR, and the results compared with healthy volunteer controls.
Results: Forty nine women were recruited. The median age was 62 years (34-87 years), 76% had T1-2 tumours, the rest being T3/4, 45% were node positive, 77% had IDC while 20% had lobular cancers. Eighty-six per cent were ER+/PR+, 10% HER 2+, and 8% were triple negative. Fifty-nine per cent received adjuvant chemotherapy, 10% trastuzumab, and 85% received adjuvant hormonal therapy. Seventy per cent have received adjuvant radiation. Median follow-up is 15 months (1-39 months). The first 29 cases have been analysed. Graphs of trial samples versus controls have been generated, and examples of positive and negative samples will be shown. Analysis of all 49 cases and follow up bloods is ongoing.
Conclusion: The women involved are keen to participate in clinical research. CTC and DTC appear present in some women with early stage breast cancer. Some molecular markers appear more prominently.
The EMPathy BCN gratefully acknowledges the support of the National Breast Cancer Foundation.