Circulating Tumor Cells as Biomarker for Monitoring Treatment Response After Surgery in Early Breast Cancer Patients Towards Improving Patients Well Being

Breast cancer is one of the most common cancers globally and a leading cause of cancer-related mortality in India, with an incidence rate of 25–30 per 100,000 women in urban areas and 10–15 per 100,000 in rural areas. Metro cities such as Hyderabad, Delhi, Mumbai, and Bangalore are the most affected, with Indian women being diagnosed nearly 10 years earlier than their Western counterparts, typically between 40–50 years of age. Alarmingly, around 60% of breast cancer cases in India are diagnosed at an advanced stage (Stage III/IV), leading to poor outcomes, with the 5-year survival rate being only 66%. Contributing factors include lack of awareness, late detection, and limited access to healthcare services. Early treatment response monitoring is essential for improving clinical outcomes and guiding personalized care. Currently, imaging remains the primary tool to assess treatment response, disease progression, and recurrence risk; however, as breast cancer is a systemic disease, cancer cells may be circulating in the blood much earlier than changes are detectable on imaging. Circulating Tumor Cells (CTCs), which are shed from primary tumors into the bloodstream, are emerging as promising biomarkers, capable of providing real-time insights into treatment response, disease progression, and recurrence risk. Evaluating the role of surgery in reducing systemic tumor burden using CTCs as biomarkers can help optimize systemic treatment planning in early breast cancer patients. This study aims to investigate the role of CTCs as biomarkers in breast cancer patients undergoing surgery to assess tumor burden reduction post-surgery and to understand patient-reported outcome measures (PROM) related to cancer worry, thereby contributing towards improving patient well-being.