No evidence for shedding of circulating tumor cells to the peripheral venous blood as a result of mammographic breast compression

Abstract

This pilot study aimed to investigate whether mammographic compression procedures might cause shedding of tumor cells into the circulatory system as reflected by circulating tumor cell (CTC) count in peripheral venous blood samples. From March to October 2012, 24 subjects with strong suspicion of breast malignancy were included in the study. Peripheral blood samples were acquired before and after mammography. Enumeration of CTCs in the blood samples was performed using the CellSearch® system. The pressure distribution over the tumor-containing breast was measured using thin pressure sensors. The median age was 66.5 years (range, 51–87 years). In 22 of the 24 subjects, breast cancer was subsequently confirmed. The difference between the average mean tumor pressure 6.8 ± 5.3 kPa (range, 1.0–22.5 kPa) and the average mean breast pressure 3.4 ± 1.6 kPa (range, 1.5–7.1 kPa) was statistically significant (p < 0.001), confirming that there was increased pressure over the tumor. The median pathological tumor size was 19 mm (range, 9–30 mm). Four subjects (17 %) were CTC positive before compression and two of these (8 %) were also CTC positive after compression. A total of seven CTCs were isolated with a mean size of 8 × 6 μm2 (range of the longest diameter, 5–12 μm). The study supports the view that mammography is a safe procedure from the point of view of tumor cell shedding to the peripheral blood.

Characteristics of circulating tumor cells in organ metastases, prognosis, and T lymphocyte mediated immune response

“…Vertebrae were more likely to form metastases, which demonstrated that different bones possess different microenvironments where CTCs are inclined to settle in. DTCs could still disseminate to other remote organs even the primary tumor has been resected for years 23. Bone metastases can be applied as the prognostic factor to colon cancer with rare occurrence of bone metastases, as well as to breast cancer with frequent occurrence of bone metastases 28.…”

Towards personalized compression in mammography: A comparison study between pressure- and force-standardization

“…A recent pilot study by Förnvik et al [27], examining the pressure distributions during mammographic compression of known lesions, found no such evidence. However, over-compression is still a cause of unnecessary pain.…”

Tumor cells are dislodged into the pulmonary vein during lobectomy

“…Many previous studies 8, 14, 15 used EpCAM-based approaches to quantify the number of tumor cells shed during surgery. While nearly all EpCAM+ cells in the peripheral circulation (circulating tumor cells) are tumor cells 16 , too many normal epithelial cells are dislodged during surgery to render EpCAM an equally good marker for intraoperatively shed tumor cells.…”