Does liquid biopsy predict breast cancer relapse?

by Dr Amit Jotwani
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Breast cancer is one of the most common cancers that affects women across the world. A complex form of cancer, it is challenging to treat. However, extensive research on the disease has helped us treat and manage it better. 

Liquid biopsy is a technique that effectively monitors the progression of breast cancer, allowing for early diagnosis and screening, prediction of prognosis, as well as detection of relapse. It is also helpful in deciding the line of treatment.

What is a liquid biopsy?

A liquid biopsy is a test that studies the tumor cells through a simple blood sample.

Effectiveness of liquid biopsy as a predictor of breast cancer relapse

A recent study published in the medical journal JAMA Oncology provides evidence suggesting the effectiveness of liquid biopsy in predicting the recurrence of breast cancer. The study suggests that liquid biopsies can be used by oncologists to predict which women, especially among those suffering from hormone receptor-positive (HR+) breast cancer, face a higher risk of having cancer recurrence. 

The study analysed the liquid biopsies for 547 women with breast cancer, five years post-diagnosis. All the women showed no signs of recurrence at this stage. The biopsy samples detected at least one circulating tumor cell in 26 women, 2.6 years later, 24 of the 547 women experienced a recurrence. 

Of these, circulating tumor cells had been found in the liquid biopsy samples of seven women, while 17 showed no evidence of tumor cells in their liquid biopsy. This meant that patients with detectable circulating tumor cells in their liquid biopsy were slightly over 13% more likely to suffer from recurrence. 

A comparison among the women based on whether their cancer was hormone receptor (HR) positive or negative showed that women with HR+ cancer were more likely to suffer a recurrence in case tumor cells were detected in their liquid biopsy. On the other hand, none of the women with HR- disease who had detectable tumor cells, suffered a recurrence. 

Implications

Using liquid biopsy may make it possible to identify patients who are at higher risk of breast cancer recurrence. This data can then be used to devise new treatment plans and explore ways to decrease the risk of recurrence.

For instance, women with HR+ sometimes receive over five years of hormone therapy (which comes with a set of serious side-effects), to prevent or delay a recurrence of breast cancer. But it isn’t always clear whether they require such aggressive treatment for that length of time. In such cases, a liquid biopsy can help make better treatment decisions by indicating the extent of risk.

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