原发性乳腺癌分子分型与新辅助化疗疗效及预后的相关性

目的 探讨原发性乳腺癌分子分型与新辅助化疗疗效及预后之间的相关性。方法 回顾性分析河南省肿瘤医院收治的204例接受新辅助化疗患者的临床病理资料,分为Luminal A、LuminalB、HER2阳性和三阴乳腺癌4种亚型,分析乳腺癌分子分型对新辅助化疗疗效及预后的预测作用。结果 204例患者中,40例（19.6％）为Luminal A亚型,46例（22.5％）为Luminal B亚型,36例（17.6％）为HER2阳性亚型,82例（40.2％）为三阴乳腺癌亚型。HER2阳性（22.2%）及三阴乳腺癌亚型（22.4%）的病理完全缓解（pCR）率明显高于Luminal A亚型（2.5％）及Luminal B亚型（6.5％）,差异有统计学意义（P=0.03）。与Luminal亚型相比,HER2阳性及三阴乳腺癌亚型具有更差的无病生存期（DFS）（P=0.001）和OS（P=0.002）;剔除获得pCR的患者,单独评价存在肿瘤残留的患者,我们发现HER2阳性及三阴乳腺癌亚型比Luminal亚型具有更差的DFS（P<0.001）和OS（P<0.001）。获得pCR的乳腺癌患者的5年DFS和总生存期（OS）均明显高于化疗后仍有癌残留的患者（P=0.002, P=0.012）。结论 相对于Luminal亚型,HER2 阳性和三阴乳腺癌亚型对新辅助化疗更为敏感,更易达到pCR;但是HER2阳性和三阴乳腺癌亚型预后反而更差。     

乳腺癌新辅助化疗后同侧内乳区淋巴结病理完全缓解的预测因素及预后价值

目的 探讨乳腺癌新辅助化疗后内乳区淋巴结病理完全缓解（ipCR）的预测因素及其对预后的影响。方法 对70例伴内乳区淋巴结转移的原发乳腺癌并接受新辅助化疗患者病例资料进行回顾性分析,根据术后病理分为ipCR组和non-ipCR组。对乳腺癌新辅助化疗后同侧ipCR的预测因素,χ 2检验、Fisher及Logistic回归分别进行单因素和多因素分析,Kaplan-Meier曲线和Cox回归进行预后分析。结果 70例患者中31例获得ipCR（44.3%）。单因素分析显示,腋窝pCR、激素受体表达水平、HER2状态与ipCR有关（P<0.05）。多因素分析显示,年龄、腋窝pCR、HER2状态是ipCR的独立预测因子。ipCR组平均DFS达96.0个月（95%CI: 49.5~84.7）,明显优于non-ipCR组为67.1个月（95%CI: 81.7~110.3, P<0.05）。ipCR组复发转移风险较non-ipCR组降低87%（HR=0.13, 95%CI: 0.04~0.44, P<0.01）。ipCR、Ki67表达水平、乳房pCR是影响患者预后的独立因素。结论 新辅助化疗后是否获得ipCR与临床病理因素存在相关性。ipCR可用于预测内乳区淋巴结转移患者的预后。     

影响年轻乳腺癌患者新辅助化疗后病理完全缓解与预后的因素分析

目的 探讨影响年轻乳腺癌患者新辅助化疗后病理完全缓解(pCR)与预后的因素。方法 回顾性分析行新辅助化疗的145例年轻乳腺癌患者临床资料,分析影响年轻乳腺癌患者新辅助化疗后pCR与预后的因素。结果 145例年轻乳腺癌患者新辅助化疗后pCR率为34.48%。ER阳性、PR阳性、临床N分期、Ki67阳性、化疗方案与pCR有关(P<0.05),HER-2、化疗周期、分子分型、临床T分期与pCR无关(P>0.05);多因素分析显示,Ki67阳性、临床N分期是影响年轻乳腺癌患者新辅助化疗后pCR的独立因素(P<0.05且OR>1)。145例年轻乳腺癌患者新辅助化疗后1年复发率37.93%。ER阳性、PR阳性、临床T分期、临床N分期、pCR与新辅助化疗后预后有关(P<0.05),HER-2、Ki67、化疗方案、化疗周期、分子分型与新辅助化疗后预后无关(P>0.05);多因素分析显示,临床T分期、pCR是影响年轻乳腺癌患者新辅助化疗后预后的独立因素(P<0.05且OR>1)。结论 Ki67阳性、临床N分期是影响年轻乳腺癌患者新辅助化疗后pCR的独立因素...     

局部进展期乳腺癌新辅助化疗前后生物标志物表达变化与疗效的相关性

目的：探讨局部进展期乳腺癌行新辅助化疗前后相关生物标志物的表达变化情况与化疗疗效的相关性。方法：采用免疫组化方法检测102例新辅助化疗前后局部进展期乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子受体－2（HER －2）、p53和增殖细胞核抗原（Ki －67）等表达,分析化疗前后生物标志物表达变化与化疗疗效的相关性。结果：ER 阴性组、PR 阴性组、Ki －67高表达组的新辅助化疗有效率分别为50．0％、49．1％、51．4％,高于 ER 阳性组26．0％、PR 阳性组25．5％、Ki －67低表达组9．4％（P ＜0．05）。Logistic 多因素回归分析显示,ER、Ki －67的表达水平是评估化疗疗效的独立因素（P ＜0．05）。Luminal 型乳腺癌总生存期高于 non －Luminal 型（Long －rank 检验,P ＜0．05）。结论：ER、Ki －67、分子亚型可作为局部进展期乳腺癌新辅助化疗疗效判断的重要预测指标。     

Ki-67与乳腺癌临床病理特征及新辅助化疗疗效的相关性

目的：分析Ki-67与乳腺癌临床病理特征对新辅助化疗（neoadjuvant chemotherapy,NCT）疗效和预后的影响,探讨NCT疗效的预测因素。方法用免疫组化法检测320例局部晚期乳腺癌患者癌组织中ER、PR、HER-2及Ki-67表达状况。进行NCT 4～6个周期后手术。分析临床病理特征与病理完全缓解率（patho-logic complete response,pCR）之间的关系。临床病理参数与疗效分析用χ2检验,影响预后因素用Cox多因素回归分析。结果 Ki-67表达与ER（r=－0.174,P=0.002）和PR（r=－0.132,P=0.019）呈负相关,与HER2（r=0.140, P=0.012）和乳腺肿瘤大小（r=0.132,P=0.019）呈正相关;ER阴性组pCR率显著高于ER阳性组（26.9%vs 7.4%,χ2=22.761,P=0.000）;PR阴性组pCR率显著高于阳性组（22.7%vs 10.9%,χ2=7.950,P=0.005）;Ki-67高表达组pCR率18.0%（41/228）优于Ki-67低表达组8.6%（8/92）（χ2=4.552,P=0.033）;化疗后Ki-67表达下降组pCR率19.8%（48/243）优于未下降组1.3%（1/77）（χ2=15.356,P=0.000）;各分子亚型间化疗疗效差异显著,Luminal A型pCR率为1.4%（1/71）,Luminal B型pCR率为15.3%（25/163）,HER2过表达型pCR率为31.3%（14/45）,三阴性型pCR率为22.0%（9/41）（χ2=20.639,P=0.000）;用Kaplan-Meier法进行生存分析,Ki-67低表达组无病生存时间（DFS）和总生存时间（OS）均优于Ki-67高表达组,两者均为P=0.034。结论 Ki-67高表达患者对化疗更敏感,但预后较差。化疗前Ki-67的表达和化疗后Ki-67变化是影响DFS独立的预后因素。ER、PR、Ki-67指数及分子分型可以作为NCT疗效的预测指标,Ki-67指数与ER、PR、HER2之间存在相关性。     

系统免疫炎性反应指数对乳腺癌新辅助化疗病理完全缓解的预测作用及其与p53的关系

目的 探讨系统免疫炎性反应指数（SII）对乳腺癌新辅助化疗（NAC）病理完全缓解（pCR）的预测作用及其与p53的关系。方法 回顾性分析387例接受新辅助化疗及手术的女性乳腺癌患者临床病理资料。Logistic回归模型进行单因素和多因素分析。结果 72例（18.6%）患者接受新辅助化疗后获得了pCR,其中低SII组48例,高SII组24例;p53阴性组39例,阳性组33例。单因素分析显示：pCR与临床T分期、激素受体（HR）状态、人表皮生长因子受体2（HER2）、Ki67值、分子分型、p53及SII相关（均P<0.05）;多因素分析显示：临床T分期、Ki67值、分子分型、p53及SII是影响乳腺癌患者pCR的独立预测因素。p53阴性的低SII组患者pCR率高于其他组。结论 SII是乳腺癌新辅助化疗病理完全缓解的独立预测因素,具有简单方便及重复性高等特点,p53阴性的低SII组患者pCR率高。     

Ki67指数预测Luminal型HER2-乳腺癌新辅助化疗疗效的临床价值

目的 探索Ki67指数预测Luminal型HER2-乳腺癌新辅助化疗(neoadjuvant chemotherapy,NCT)疗效中的价值.方法 采用免疫组织化学法检测159例NCT治疗的乳腺癌患者乳腺组织标本中Ki67、ER、PR及HER2表达状况,用x2检验分析Ki67与病理学完全缓解(pathological complete response,pCR)之间的关系.结果 将本组病例分成两组,Ki67指数＜30％(85例)为低表达组和Ki67指数≥30％为高表达组(74例),Ki67高表达组pCR率明显高于低表达组(21.6％ vs 2.4％,P=0).依据敏感度与特异度之和最大化原则计算Ki67预测pCR的最佳界值为37％,ROC曲线下面积为0.832,标准误为0.039,P＜ 0.01.结论 在Luminal型HER2-乳腺癌中,Ki67高表达患者对化疗更敏感,Ki67预测pCR的界值为37％,可作为临床医师选择治疗策略的参考依据.     

乳腺癌新辅助化疗中肿瘤标志物检测的临床意义

目的检测肿瘤标志物在新辅助化疗乳腺癌中的表达,探讨新辅助化疗患者中ER、PR、c-erbB2和Ki67的表达及临床意义.方法用免疫组织化学法检测ER、PR、c-erbB2和Ki67在89例新辅助化疗乳腺癌组织中的表达状况,分析上述指标与化疗的关系.结果新辅助化疗总有效率89.9%,其中完全缓解CR32.6%,部分缓解PR57.3%,病理完全缓解pCR17.9%,疾病稳定SD10.5%,无恶化病例.ER/PR表达与疗效有关（P〈0.05）,c-erbB2、Ki67表达与化疗疗程无关.结论激素受体阴性者对新辅助化疗的敏感性较高,新辅助化疗肿瘤标志物的检测可以为临床评价疗效判断预后提供依据.     

肿瘤浸润淋巴细胞在cT1N0M0期乳腺癌淋巴结转移中的预测价值

 目的 探讨cT1N0M0期乳腺癌患者肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte,TIL）与淋巴结转移的相关性, 以及TIL密度在预测患者前哨淋巴结转移 （sentinel lymph node metastasis,SLNM） 中的价值。方法 回顾性分析2008年1月至 2016年12月于本院接受手术治疗的cT1N0M0 期乳腺癌患者的临床资料。术前在活检标本中进行 TIL 密度的组织病理学评估。采用多因素logistic回归以及受试者工作特征（ROC）曲线分析TIL预测SLNM的价值。结果  共153例cT1N0M0期乳腺癌患者纳入分析, 其中30例（19.6%）患者发生SLNM。TIL密度与雌激素受体（ER）状态（P<0.001）、孕激素受体（PgR）状态（P=0.003）、人表皮生长因子受体2（HER2）状态（P=0.029）、Ki67表达（P=0.025）、核分级（P=0.026）相关。多因素logistic回归显示, TIL密度（OR=1.40,95%CI：1.15~1.71,P=0.001）是影响cT1N0M0期乳腺癌SLNM的独立因素, 其ROC曲线下面积（AUC）为0.755 （95%CI：0.680~0.830,P<0.001）。结论 TIL密度与cT1N0M0期乳腺癌SLNM密切相关, 可能是SLNM潜在的预测指标。     

影响青年乳腺癌患者新辅助化疗后病理完全缓解和预后的病理因素分析

目的:探讨影响青年乳腺癌患者新辅助化疗（neoadjuvant chemotherapy,NAC）后病理完全缓解（pathological complete response,pCR）和预后的临床病理因素。方法:回顾性分析2010年01月至2018年12月我院甲乳外科收治年龄≤35岁行NAC的女性乳腺癌患者的临床病理资料。NAC后依据Miller-Payne评分系统,将患者分为pCR组和非pCR组。探讨临床病理因素对青年乳腺癌患者pCR、复发转移和死亡的影响,同时分析pCR与无病生存期（disease free survival,DFS）与总生存期（overall survival,OS）之间的相关性。结果:168例患者中pCR 37例,pCR率为22.0%。体质量指数(body mass index,BMI)、术前淋巴结状态、雌激素受体（estrogen receptor,ER）、孕激素受体（progesterone receptor,PR）、人类表皮生长因子受体2（human epidermal growth factor receptor-2,HER-2）、Ki-67、p53及分子分型与青年乳腺癌患者NAC后的pCR率关系密切（P＜0.05）。肿瘤大小、术前淋巴结状态、ER、PR、HER-2、p53及分子分型影响患者的复发转移和死亡（P＜0.05）,同时肿瘤大小、术前淋巴结状态、组织学分级、ER、PR、HER-2、Ki-67及分子分型均是DFS和OS的独立影响因素（P＜0.05）。66例复发转移患者中pCR患者7例,占pCR患者的18.9%（7/37）,pCR组和非pCR组DFS比较差异具有统计学意义（P＜0.05）。38例死亡患者中pCR患者3例,占pCR患者的8.1%（3/37）,pCR组和非pCR组OS比较差异具有统计学意义（P＜0.05）。结论:影响青年乳腺癌患者pCR和预后的临床病理因素较多,获得pCR的患者具有更好的远期预后。     

恶性肿瘤家族史与乳腺癌患者临床病理特征的关系CSCD

目的探讨恶性肿瘤家族史(MN-FH)与乳腺癌患者临床病理特征之间的关系。方法回顾性分析东南大学附属中大医院2016年1月—2018年12月收治的417例乳腺癌患者的临床病理资料,根据有无MN-FH分成两组。采用χ2检验分析两组患者临床病理特征之间的关系。结果417例乳腺癌患者中,有MN-FH者67例(16.1%)。有MN-FH组的患者有更高比例的脉管癌栓(P=0.046)和淋巴结转移(P=0.023),肿瘤更易表现为ER阴性(P=0.025)、PR阴性(P=0.031)和HER2阳性(P=0.041)。进一步亚组分析发现,有乳腺癌家族史的患者较无MN-FH的患者有更晚的肿瘤分期(P=0.011),肿瘤更易表现为三阴性和HER2扩增型(P=0.010)。其他恶性肿瘤家族史的患者较无MN-FH的患者有更高比例的脉管癌栓(P=0.036)和淋巴结转移(P=0.034)。结论有MN-FH的乳腺癌患者肿瘤恶性程度更高,对于有MN-FH的人群体检非常重要。     

Predictive role of molecular subtypes in response to neoadjuvant chemotherapy in breast cancer patients in Northeast China

Introduction: Breast cancer is increasingly regarded as a heterogeneous disease which can be classified into distinct molecular subtypes with prognostic significance. Materials and methods: ER, PR, HER2 and ki-67 were used to divided 102 breast cancers treated with neoadjuvant chemotherapy ( NCT ) into 4 subtypes: luminal A (ER+,PR+,HER2-, and ki-67 ≤14%), luminal B (ER+, PR+,HER2- and ki-67>14% ; ER+ and/or PR+, HER2+), HER2-overexpression (ER-, PR- and HER2+) and triple-negative (ER-, PR-,and HER2-). Results: Among 102 patients, a pCR was seen in 16 (15.7%) patients. The pathologic complete remission (pC) rates according to different subtypes are as follows: luminal A, 0 of 20 (0.0%), luminal B, 2 of 23 (8.7%), HER2-overexpressio,n 4 of 18 (22.2%), and triple-negative, 10 of 41 (24.4%) (p=0.041). In triple-negative subtype patients, the rates of pCR differed significantly among the 3 chemotherapy regimens with 5.6% (1/18) for CEF (cyclophosphamide, epirubicin and flurouracil), 20.0% (1/5) for TE (docetaxel and epirubicin) and 44.4% (8/18) for TCb (docetaxel and carboplatin) (p=0.024). In locally advanced breast cancer patients, the rates of pCR seem to differ among the 3 chemotherapy regimens with 6.7% (2/30) for CEF, 0.0% (0/8) for TE and 23.1% (6/26) for TCb, but this did not attain statistical significance (p>0.05). Conclusions: Molecular subtypes are good predictors for response to NCT in breast cancer patients in Northeast China. Compared with luminal A tumors, HER2-overexpression and triple-negative subtypes are more sensitive to NCT. For triple-negative breast cancer, we concluded that the TCb combination is a promising NCT regimen. Our results also indicated that the TCb combination is promising for the treatment of locally advanced breast cancer.     

Correlation between Ki67 and Histological Grade in Breast Cancer Patients Treated with Preoperative Chemotherapy

Background and Aim: Breast cancer (BC) is a heterogeneous disease and cell proliferation markers may helpto identify subtypes of clinical interest. We here analyzed the correlation between cell proliferation determinedby Ki67 and HG in BC patients undergoing preoperative chemotherapy (PCT). Materials and Methods: Weobtained clinical/pathological data from patients with invasive BC treated at our institution from 1999 until2012. Expression of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor type2 (HER2) and Ki67 were determined by immuno-histochemistry (IHC). Clinicopathological subtypes weredefined as: Luminal A, ER and/or PR positive, HER2 negative, HG 1 or 2; Luminal B, ER and/or PR positive,HER2 negative or positive and/or HG 3; triple negative (TN), ER, PR and HER2 negative independent ofHG; HER2 positive, ER, PR negative and HER2 positive, independent of HG. By using Ki67, a value of 14%separated Luminal A and B tumors, independently of the histological grade. We analyzed correlations betweenKi67 and HG, to define BC subtypes and their predictive value for response to PCT. Results: 1,560 BC patientswere treated in the period, 147 receiving PCT (9.5%). Some 57 had sufficient clinicopathological information tobe included in the study. Median age was 52 years (26-72), with 87.7% invasive ductal carcinomas (n=50). Weperformed IHC for Ki67 in 40 core biopsies and 50 surgical biopsies, 37 paired samples with Ki67 before andafter chemotherapy being available. There was no significant correlation between Ki67 and HG (p=0.237), bothcategorizing patients into different subtypes. In most cases Ki67 decreased after PCT (65.8%). Only 3 patientshad pathologic complete response (cPR). Conclusions: In our experience we did not find associations betweenKi67 and HG. Determination of clinicopathological luminal subtypes differs by using Ki67 or HG.     

Expression of p53 Breast Cancer in Kurdish Women in the West of Iran: a Reverse Correlation with Lymph Node Metastasis

Background: In breast cancer (BC), it has been suggested that nuclear overexpression of p53 protein might be an indicator of poor prognosis. The aim of the current study was to evaluate the expression of p53 BC in Kurdish women from the West of Iran and its correlation with other clinicopathology figures. Materials and Methods: In the present retrospective study, 231 patients were investigated for estrogen receptor (ER) and progesterone receptor (PR) positivity, defined as 10% positive tumor cells with nuclear staining. A binary logistic regression model was selected using Akaike Information Criteria (AIC) in stepwise selection for determination of important factors. Results: ER, PR, the human epidermal growth factor receptor 2 (HER2) and p53 were positive in 58.4%, 55.4%, 59.7% and 45% of cases, respectively. Ki67 index was divided into two groups: 54.5% had Ki67<20% and 45.5% had Ki67 20%. Of 214 patients, 137(64%) had lymph node metastasis and of 186 patients, 122(65.6%) had vascular invasion. Binary logistic regression analysis showed that there was inverse significant correlation between lymph node metastasis (P=0.008, OR 0.120 and 95%CI 0.025-0.574), ER status (P=0.006, OR 0.080, 95%CI 0.014-0.477) and a direct correlation between HER2 (P=005, OR 3.047, 95%CI 1.407-6.599) with the expression of p53. Conclusions: As in a number of studies, expression of p53 had a inverse correlation with lymph node metastasis and ER status and also a direct correlation with HER2 status. Also, p53-positivity is more likely in triple negative BC compared to other subtypes.     

不同分子亚型浸润性乳腺癌中p53基因及Ki-67抗原的表达及意义

目的探讨p53基因及Ki-67抗原在不同分子亚型浸润性乳腺癌中的表达及意义。方法采用免疫组化法检测275例浸润性乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）、p53基因及Ki-67抗原的表达水平。结果p53在激素受体阳性组（175例）、HER-2受体阳性组（60例）、三阴性乳腺癌组（40例）中的表达率分别为29．7％,55．0％和75．0％,三组间差异有统计学意义（χ^2=32．924,P〈0．05）,以三阴性组表达最高。Ki-67在激素受体阳性组、HER-2受体阳性组、三阴性乳腺癌组中的表达率分别为74．3％,95．0％和95．0％,三组间差异有统计学意义（χ^2=18．355,P〈0．05）,以三阴性组和HER2阳性组表达最高。p53基因和Ki-67抗原的表达阳性率在有腋窝淋巴结转移的乳腺癌组中高于无腋窝淋巴结转移组,差异有统计学意义（χ^2=5．257,P〈0．05;χ^2=12．664,P〈0．05）。结论在乳腺癌的分子亚型中联合检测p53基因及Ki-67抗原可以作为乳腺癌发生、发展的评价指标,更有助于指导其临床治疗和判断预后。     

Molecular subclasses of breast cancer: how do we define them? The IMPAKT 2012 Working Group Statement

The 2012 IMPAKT task force investigated the medical usefulness of current methods for the classification of breast cancer into the ‘intrinsic’ molecular subtypes (luminal A, luminal B, basal-like and HER2). A panel of breast cancer and/or gene expression profiling experts evaluated the analytical validity, clinical validity and clinical utility of two approaches for molecular subtyping of breast cancer: the prediction analysis of microarray (PAM)50 assay and an immuno-histochemical (IHC) surrogate panel including oestrogen receptor (ER), HER2 and Ki67. The panel found the currently available evidence on the analytical validity and clinical utility of Ki67 based on a 14% cut-off and PAM50 to be inadequate. The majority of the working group members found the available evidence on the analytical validity, clinical validity and clinical utility of ER/HER2 to be convincing. The panel concluded that breast cancer classification into molecular subtypes based on the IHC assessment of ER, HER2 and Ki67 with a 14% cut-off and on the PAM50 test does not provide sufficiently robust information to modify systemic treatment decisions, and recommended the use IHC for ER and HER2 for the identification of clinically relevant subtypes of breast cancers. Methods for breast cancer classification into molecular subtypes should, however, be incorporated into clinical trial design.     

Prognostic Value of Circulating Tumor Cells According to Immunohistochemically Defined Molecular Subtypes in Advanced Breast Cancer

BackgroundBreast cancer is a heterogeneous disease. Circulating tumor cell (CTC) enumeration might be useful to identify different risk categories within each molecular subtype.MethodsWe retrospectively analyzed 203 consecutive patients with metastatic breast cancer with baseline CTC enumeration performed with CellSearch (Veridex Corp, Warren, NJ) between March 2005 and July 2011. Patients were categorized into 3 prognostic groups based on the number of CTCs (0, 1-4, and ≥ 5) and into 5 categories based on tumor biological characteristics: luminal-A (estrogen receptor [ER] and progesterone receptor [PR] > 1%, grade 1/2, human epidermal growth factor 2 [HER2]-negative [HER2^?], Ki67 value < 14%); luminal-B (ER and/or PR > 1%, grade 3, HER2^?, Ki67 value > 14%); luminal-B HER2–positive [HER2⁺] (ER and/or PR > 1%, any grade, HER2⁺, Ki-67 value any); HER2⁺ (HER2 overexpressed/fluorescence in situ hybridization [FISH] amplified, ER and PR absent); triple negative (TN) (ER and PR 0%, HER2 not overexpressed/FISH not amplified).ResultsMedian age was 57 years (range 31-78 years). Twenty-seven patients (13.3%) had luminal-A category, 105 (51.7%) patients had luminal-B, 29 (14.3%) patients had luminal-B HER2⁺, 24 patients (11.8%) had HER2⁺, and 18 patients (8.9%) had TN. CTCs were mostly found in patients with luminal-A/luminal-B HER2^? subtype. At multivariable analysis, CTC count was a significant predictive factor for overall survival (OS) in all molecular subtypes (log-rank P < .01). Patients with 0 CTCs/7.5 mL blood and all subtypes, except HER2⁺, seem to perform better compared with other categories.ConclusionThese findings confirm CTCs as an important prognostic factor for metastatic breast cancer in all molecular subtypes. Larger studies could help identify metastatic breast cancer subgroups in which CTC analysis would be particularly useful.