Publications

Background: Early metastasis detection has an implication to increase overall survival in breast cancers (BC) patients. Circulating Tumor Cells (CTCs) have a role to detect minimal residual disease (MRD). In an ongoing cohort we evaluated the association of CTC dynamics, pre and post operative surgery with a curative intent. Further we evaluated cancer-worry in post-surgical BC patients.

Methods: 75 CTC tests were performed on 55 female BC patients, of which 20 were follow-up cases. While in an ongoing IEC approved clinical cohort of 10 BC patients enrolled through a quantitative, non-probability purposive sampling method. CTC counts, including clusters, were measured both pre surgery and 24 hours post-surgery. PD-L1 expression on CTCs is noted using CDSCO approved OncoDiscover platform. PROM was assessed using the Breast-Q Cancer Worry scale (a validated subscale reflecting fear of recurrence and worry). The statistical analysis compared PROM scores to CTC patterns (increase, persistence, or clearance). A paired sample t-test was applied to compare pre and post-operative PROM scores, thereby evaluating changes in cancer worry within the same patients before and after surgery in relation to CTC counts.

Results: Among 75 tests performed in 55 BC patients, 84.5% were CTC +, with a mean of 1.43 per test. While, longitudinally monitoring of 10 female breast cancer patients who have underwent Sx, 6 received NACT followed by breast-conserving surgery, while 4 underwent surgery without prior chemotherapy. 40% (4/10) showed a fall in CTCs and in that 20% (2/10) showed full clearance of CTCs after the surgery. Patients with increased post-surgery CTCs reported a significant increase in cancer worry with score before surgery was 43.9, which increased to 51.8 after surgery. Findings suggest critical need for targeted emotional and psychological support in the post-surgical period and disclosure of role of CTC in monitoring MRD.

Conclusion: Monitoring CTCs strengthened its potential as an early indication of residual disease by offering crucial clinical insights into tumour activity during the operative phase. Further validation of these findings and inform more integrated, patient-centred care approaches to reduce the burden of late-stage Cancer.