Association of Perioperative Cell-free DNA (cfDNA) Concentrations with Risk of Recurrence in Patients with Breast Cancer

Abstract Background: Circulating cell-free DNA (cfDNA) is a potential biomarker of disease status in cancer patients and provides valuable diagnostic and prognostic information in breast cancer. In this study, we sought to quantify the cfDNA concentrations in the perioperative period and to investigate its prognostic relevance in breast cancer patients.Methods: Sixty-three (n=63) breast cancer patients undergoing curative surgery were screened for inclusion. Blood samples were collected: pre-operatively (Pre-op), post-operatively (POD) within weeks 1-2, weeks 3-4 and weeks 5-12 following surgery. cfDNA was extracted and quantified using nanodrop spectrophotometer. All patients were followed up for 5 years.Results: The median age was 52(26-84) years. During the perioperative period, patients with high cfDNA concentrations(cutoff:480ng/ml) had inferior recurrence free survival (RFS) than those with lower cfDNA concentrations (pre-operative period: median RFS: 30(3-60) months versus 60(6-60) months (p<0.0001), post-operative period: median RFS: 24(3-60) months versus 60(6-60) months (p<0.0001). Multivariate Cox regression analysis showed that post op cfDNA concentration (p=0.017), subtypes (p=0.011) and tumour size (p=0.006) were negative prognostic factor for RFS in the pre-operative period and post-operative period.Conclusion: Our study demonstrated the prognostic ability of perioperative cfDNA concentrations in breast cancer patients. Further, prospective studies are warranted to validate its clinical utility in breast cancer.