Circulating tumor cells to determine risk of recurrence

My oncologist says they only used them to monitor stage 4. I am honestly not sure how we ever know we are in stage 4 !

I am doing Signatera . I have had one blood draw (February )which showed no circulating blood tumor cells. My breast cancer was stage 1a. I was diagnosed in August 2021. My oncologist was willing to let me do Signatera . I have another blood draw in August . It is suggested to do blood draw every 6 months. I am not taking hormone therapy so I wanted to be proactive about my health and possible recurrence. You don’t have to be stage 4 to do these blood tests. Not all oncologist are willing to let their pts have this testing. If you do get a positive result it is then the question of what do you do next.

Breast cancer cells circulate in lymph Fluid too. Can it be detected too?

I don’t know the answer to that.

Thanks for sharing! I'm hoping liquid biopsies can further be researched and recommended as a tool for "surveillance". My oncologist at Dana Farber mentioned they don't do blood work. I was diagnosed Nov 2022, ILC , lumpectomy and 19 rounds of radiation and currently on Letrozole since Feb. I don't see onco until October for a mammo which is one year since my last for a new baseline. I really thought a 6 month scan would be recommended but nope. Does insurance cover Signatera and does a doctor have to "order". Appreciate any intel. xoxo

You can contact the company Natera in CA. They do the signatera test. They will answer your insurance questions and they will send a phlebotomist to your home for blood draw but tissue sample must be sent by the hospital/lab where surgery tissue is stored. I do believe a script is required by your doc.

Once established blood draw can be every 3 months if desired. I’m on a 6 mos. schedule. Second one due in October.

I was Stage 2 , had surgery and now mos. 16 on AI. Established with Signatera in April ( negative) and on 6 mos. Schedule.

This technology is gaining traction rapidly. Some say they don’t know what to do with a positive result… that said… my oncologist said she would be looking towards the Meds that target metastatic BC for early intervention if signatera were to show a positive result.

This technology appears to be on a fast track for research on application strategies. It was first used for colon cancer so it’s not JUST arriving in the cancer arena.

How have you done with Letrozole? I just started 2 weeks ago.

Chiming in here, as I am sure you are not the only one who wonders this.

Stage 4 is when the cancer is detected away from the original region. As an example, I was Stage 3b because it was in the breast, lymph nodes in armpit, chest wall, and skin.

If they had found it in my blood, lungs, farther lymph nodes, or another organ it would have been Stage 4.

@seathink you may have misunderstood. I know what stage 4 means. The problem we have is how it can be detected early, without routine tests or scans.

After we finish treatment, many of us don't even see an oncologist anymore. I message them if I have intense bone pain, for instance, and they just say to see my PCP for an x-ray.

Every instance of stage 4 that I know personally has been found randomly during imaging for something else entirely.

The possibility of blood tests for detection is a major breakthrough.