Circulating tumor cells in lobular versus ductal metastatic breast cancer
5 affiliations
- 1Breast Oncology Section, Department of Internal Medicine, University of Michigan Medical School, CCC 6431, 1500 E. Medical Center Drive, MI Ann Arbor, 48109-5942 USA
- 2University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, MI USA
- 3Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI USA
- 4Department of Pathology and Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI USA
- 5Department of Pediatrics and School of Information, University of Michigan, Ann Arbor, MI USA
Abstract
Purpose: Infiltrating lobular carcinoma (ILC) accounts for ~ 10% of all invasive breast cancer histologies. ILC is associated with worse prognosis than infiltrating ductal cancer. Circulating tumor cells (CTCs) are commonly elevated in metastatic breast cancer (mBC) and elevated levels of CTCs are associated with worse prognosis in breast cancers. We investigated CTC incidence in ILC in two patient cohorts.
Methods: Data from electronic medical records at the University of Michigan were identified using the EMERSE search engine to assess CTC levels in patients with mBC, using CellSearch®. Findings were validated in a separate cohort of mBC patients who participated in a research protocol where CTC were analyzed.
Results: Within the EMERSE cohort of 218, 38 (17%), 29 (13%) and 151 (69%) patients, had lobular, mixed, and ductal mBC subtype, respectively. Overall, 101/218 (46%) patients had elevated CTC (≥ 5/7.5 ml whole blood). In this cohort, patients with ILC were more likely to have elevated CTCs (28/38; 74%) compared to those with mixed (14/29; 48%) or ductal (59/151; 39%) mBC (p = 0.001). In multivariate regression, patients with ILC were seven times more likely than ductal mBC to have elevated CTCs. These data were validated in 146 separate mBC patients in the research cohort. Elevated CTCs were detected in 79%, 31%, and 36% of patients with lobular, mixed and ductal mBC, respectively.
Conclusion: CTC are more commonly elevated and tend to be higher in magnitude in patients with lobular compared to ductal mBC. CTC levels in mixed ductal-lobular morphology numerically more resemble ductal mBC.
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BibTeX
@article{dolce2026circulating,
title = {{Circulating tumor cells in lobular versus ductal metastatic breast cancer}},
author = {Emily M. Dolce and Elizabeth P. Darga and Nicholas C. Henderson and Dafydd G. Thomas and David A. Hanauer and Arul M. Chinnaiyan and Erin F. Cobain and N. Lynn Henry and Costanza Paoletti and Andi K. Cani and Daniel F. Hayes},
journal = {Breast Cancer Research and Treatment},
year = {2026},
month = oct,
doi = {10.1007/s10549-026-08111-3},
url = {https://doi.org/10.1007/s10549-026-08111-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Circulating tumor cells in lobular versus ductal metastatic breast cancer
AU - Emily M. Dolce
AU - Elizabeth P. Darga
AU - Nicholas C. Henderson
AU - Dafydd G. Thomas
AU - David A. Hanauer
AU - Arul M. Chinnaiyan
AU - Erin F. Cobain
AU - N. Lynn Henry
AU - Costanza Paoletti
AU - Andi K. Cani
AU - Daniel F. Hayes
PY - 2026
DA - 2026/10/26
JO - Breast Cancer Research and Treatment
DO - 10.1007/s10549-026-08111-3
UR - https://doi.org/10.1007/s10549-026-08111-3
AB - Purpose: Infiltrating lobular carcinoma (ILC) accounts for ~ 10% of all invasive breast cancer histologies. ILC is associated with worse prognosis than infiltrating ductal cancer. Circulating tumor cells (CTCs) are commonly elevated in metastatic breast cancer (mBC) and elevated levels of CTCs are associated with worse prognosis in breast cancers. We investigated CTC incidence in ILC in two patient cohorts. Methods: Data from electronic medical records at the University of Michigan were identified using the EMERSE search engine to assess CTC levels in patients with mBC, using CellSearch®. Findings were validated in a separate cohort of mBC patients who participated in a research protocol where CTC were analyzed. Results: Within the EMERSE cohort of 218, 38 (17%), 29 (13%) and 151 (69%) patients, had lobular, mixed, and ductal mBC subtype, respectively. Overall, 101/218 (46%) patients had elevated CTC (≥ 5/7.5 ml whole blood). In this cohort, patients with ILC were more likely to have elevated CTCs (28/38; 74%) compared to those with mixed (14/29; 48%) or ductal (59/151; 39%) mBC (p = 0.001). In multivariate regression, patients with ILC were seven times more likely than ductal mBC to have elevated CTCs. These data were validated in 146 separate mBC patients in the research cohort. Elevated CTCs were detected in 79%, 31%, and 36% of patients with lobular, mixed and ductal mBC, respectively. Conclusion: CTC are more commonly elevated and tend to be higher in magnitude in patients with lobular compared to ductal mBC. CTC levels in mixed ductal-lobular morphology numerically more resemble ductal mBC.
SN - 0167-6806
SN - 1573-7217
ER -