203P - Comparative evaluation of receptor status of primary tumor cells, metastasis, recurrence and circulating cancer cells in breast cancer patients

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Tatyana Grydinskaya
Citation Annals of Oncology (2014) 25 (suppl_4): iv58-iv84. 10.1093/annonc/mdu326
Authors T. Grydinskaya1, O. Kovalyov2, D. Tsvietaieva-Berest2
  • 1Oncology, State institution Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Public Health of Ukraine, 69096 - zaporozhye/UA
  • 2Oncology, State institution Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Public Health of Ukraine, zaporozhye/UA



To study the influence of phenotypic heterogeneity of a primary tumor, metastases and circulating tumor cells at different stages of tumor progression as a cause of therapeutic resistance in breast cancer patients.


The study involved 120 patients with operable breast cancer with the stage T1-4N0-3M0-1 at the age of 32-80 years (average age–59.49 ± 1.08 years). The patients were divided into 3 groups according to the staging of the disease:

1) the I group -TI-4N1-2M0 (breast tumor + metastasis in one or more regional lymph nodes)

2) theII group -T recM0-1 (recurrences or distant metastases in breast cancer patients)

3)the III group -T recM0-1 (i+), (circulating cancer cells in the blood of breast cancer patients)

The tissue samples taken from 93 patients (60 persons of the I group and 33 persons of the II group) were test material in the I and II group. 120-150 ml of venous blood taken from 27 patients was test material in the III group.


1) The objective reductionof estrogen(14.7% (p < 0.05).) and progesterone(16.81%(p < 0.05).) receptor expression is observed in distantmetastasisand late recurrence foci as compared to the primary tumor.

2) The objective increase in Her/2neu expression level (59.8%(p < 0.01).)was noted in the distant metastasis and late recurrence foci.

3) The immunophenotypeof CTCs in 52% (p < 0.05) cases does not correspond to the immunohistochemicalstatus of the primary tumor due to appearance ofestrogen and progesterone negative cells in blood, which may be caused by biological heterogeneity ofCTCsand imperfection of methods of detectingCTCsin blood.


1) As the disease progresses in the foci of breast cancer metastases and recurrences, the level of estrogen and progesterone receptor expression is reduced and Her/2neu expression level is increased.

2) In most cases the immunophenotypeof CTCs does not correspond to the immunohistochemistry status of a primary tumor.

3) In order to customize the treatment it is appropriate to determine the receptor status of cells in each focus of recurrence or metastasis, as well as the one of CTCs.


All authors have declared no conflicts of interest.