ArticleBreast cancer research : BCR2014
International study on inter-reader variability for circulating tumor cells in breast cancer.
Article in Breast cancer research : BCR, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Circulating tumor cell status monitors the treatment responses in breast cancer patients: a meta-analysis.Scientific reports · 2017Pooled it
- Concurrent genomic assessment of circulating tumour cells and ctDNA to guide therapy in metastatic breast cancer.BMC cancer · 2025Article
- Representation learning enables robust single cell phenotyping in whole slide liquid biopsy imaging.Scientific reports · 2025Article
- Cluster-based human-in-the-loop strategy for improving machine learning-based circulating tumor cell detection in liquid biopsy.Patterns (New York, N.Y.) · 2025Article
- Liquid Biopsy in Breast Cancer.Geburtshilfe und Frauenheilkunde · 2020Article
- Prognostic value of HER2 status on circulating tumor cells in advanced-stage breast cancer patients with HER2-negative tumors.Breast cancer research and treatment · 2020Article
- Circulating Tumor Cells in Early Breast Cancer.JNCI cancer spectrum · 2019Article
- HER-2 status of circulating tumor cells in a metastatic breast cancer cohort: A comparative study on characterization techniques.PloS one · 2019Article
- How to Agree on a CTC: Evaluating the Consensus in Circulating Tumor Cell Scoring.Cytometry. Part A : the journal of the International Society for Analytical Cytology · 2018Article
- Circulating tumor cells, tumor-derived extracellular vesicles and plasma cytokeratins in castration-resistant prostate cancer patients.Oncotarget · 2018Article
- Integrating liquid biopsies into the management of cancer.Nature reviews. Clinical oncology · 2017Review
- Article
- Prognostic Impact of HER2 and ER Status of Circulating Tumor Cells in Metastatic Breast Cancer Patients with a HER2-Negative Primary Tumor.Neoplasia (New York, N.Y.) · 2016Article
- Cultured circulating tumor cells and their derived xenografts for personalized oncology.Asian journal of urology · 2016Review
- Review: circulating tumor cells in the practice of breast cancer oncology.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2016Review
- Clinical and biological significance of circulating tumor cells in cancer.Molecular oncology · 2016Review
- Gene expression profiling and DNA methylation analyses of CTCs.Molecular oncology · 2016Review
- Circulating tumor cells in breast cancer.Molecular oncology · 2016Review
- Development of circulating tumor cell-endocrine therapy index in patients with hormone receptor-positive breast cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2015Article
- Can circulating tumor cells predict resistance in metastatic breast cancer?Clinical cancer research : an official journal of the American Association for Cancer Research · 2015Article
Corrections and comments
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Authors and funding
42 authors at 18 institutions in 10 countries.
Funding
Abstract
introductionCirculating tumor cells (CTCs) have been studied in breast cancer with the CellSearch® system. Given the low CTC counts in non-metastatic breast cancer, it is important to evaluate the inter-reader agreement.
methodsCellSearch® images (N = 272) of either CTCs or white blood cells or artifacts from 109 non-metastatic (M0) and 22 metastatic (M1) breast cancer patients from reported studies were sent to 22 readers from 15 academic laboratories and 8 readers from two Veridex laboratories. Each image was scored as No CTC vs CTC HER2- vs CTC HER2+. The 8 Veridex readers were summarized to a Veridex Consensus (VC) to compare each academic reader using % agreement and kappa (κ) statistics. Agreement was compared according to disease stage and CTC counts using the Wilcoxon signed rank test.
resultsFor CTC definition (No CTC vs CTC), the median agreement between academic readers and VC was 92% (range 69 to 97%) with a median κ of 0.83 (range 0.37 to 0.93). Lower agreement was observed in images from M0 (median 91%, range 70 to 96%) compared to M1 (median 98%, range 64 to 100%) patients (P < 0.001) and from M0 and <3CTCs (median 87%, range 66 to 95%) compared to M0 and ≥3CTCs samples (median 95%, range 77 to 99%), (P < 0.001). For CTC HER2 expression (HER2- vs HER2+), the median agreement was 87% (range 51 to 95%) with a median κ of 0.74 (range 0.25 to 0.90).
conclusionsThe inter-reader agreement for CTC definition was high. Reduced agreement was observed in M0 patients with low CTC counts. Continuous training and independent image review are required.
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