To the Editor We read with great interest the article by Sparano et al,1 who evaluated the association of the presence of circulating tumor cells (CTCs) in a peripheral blood sample obtained approximately 5 years after diagnosis with late clinical recurrence of operable human epidermal growth factor receptor 2–negative breast cancer (BC). The authors concluded that a positive CTC assay result 5 years after diagnosis of estrogen receptor–positive BC provided independent prognostic information for late clinical recurrence. This impressive finding raises 2 important issues.
Liu B, Dong K, Dong R. Techniques and Thresholds for Quantifying Circulating Tumor Cells in Breast Cancer. JAMA Oncol. 2019;5(4):573–574. doi:10.1001/jamaoncol.2018.7217
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