Circulating tumor cells (CTC) have been implicated in the hematogenous spread of cancer. To investigate the fluid phase of cancer from a physical sciences perspective, the multi-institutional Physical Sciences-Oncology Center (PS-OC) Network performed multidisciplinary biophysical studies of single CTC and CTC aggregates from a patient with breast cancer. CTCs, ranging from single cells to aggregates comprised of 2-5 cells, were isolated using the high-definition CTC assay and biophysically profiled using quantitative phase microscopy. Single CTCs and aggregates were then modeled in an in vitro system comprised of multiple breast cancer cell lines and microfluidic devices used to model E-selectin mediated rolling in the vasculature. Using a numerical model coupling elastic collisions between red blood cells and CTCs, the dependence of CTC vascular margination on single CTCs and CTC aggregate morphology and stiffness was interrogated. These results provide a multifaceted characterization of single CTC and CTC aggregate dynamics in the vasculature and illustrate a framework to integrate clinical, biophysical, and mathematical approaches to enhance our understanding of the fluid phase of cancer.circulating tumor cell; metastasis; breast cancer; cell lines; fluid dynamics; physics of cancer; hemodynamics; quantitative phase microscopy; microfluidics; immersed finite element method WHILE THE PRESENCE of circulating tumor cells (CTCs) in the vasculature has been implicated in the metastatic cascade of epithelial carcinomas, new evidence has revealed a putative role of CTC aggregates as a potential form of stromal-assisted metastasis across a variety of epithelial tumor types (6). In concert, the presence of homotypic interactions among CTCs leading to aggregation occurring at sites of endothelial attachment suggest the involvement of CTC aggregates in the hematogenous dissemination of cancer. Despite compelling evidence suggesting a role for CTC aggregates in metastatic progression (28), the physics underlying CTC vascular transport including the influence of blood flow, coagulation, intercellular adhesion, and collisions with cells of the vasculature, such as red blood cells (RBCs) and endothelial cells (ECs), remains poorly understood. Better physical understanding of CTC transport and mechanobiology could enable, for example, new strategies to monitor patient response to chemotherapy (22).Here, we demonstrate a multidisciplinary approach (29) that utilizes clinical measurements on single CTCs and CTC aggregates from a patient with breast cancer as a quantitative guide in the rational design of in vitro and in silico models to investigate the dynamics of CTC transport in the vasculature. Using the high-definition (HD) CTC assay to identify circulating tumor cells in the blood, coupled with quantitative phase microscopy (QPM) to quantify the subcellular density organization of CTCs, we profiled the biophysical properties of CTCs in a patient with breast cancer. These metrics, including geometric and density features,...