Ann Arbor Times

Doctors from the University of Michigan and the University of Kansas have found that analyzing cancer cells in the blood may help determine which breast cancer patients need more aggressive treatment. Their study, published in Science Advances, focused on women diagnosed with ductal carcinoma in situ (DCIS), an early stage of breast cancer where the disease has not yet spread.

About a quarter of the 2.3 million women living with breast cancer are diagnosed at this early stage. Although DCIS generally has a good prognosis, between 10% and 53% of untreated cases can become invasive. Because it is difficult to predict how each patient’s cancer will progress, doctors often recommend surgery for all DCIS patients, sometimes followed by radiation or anti-hormonal therapy.

“Since early detection can save lives, physicians are now recommending mammograms at younger ages, so more young women have to make some life-altering choices,” said Sunitha Nagrath, Dwight F. Benton Professor of Chemical Engineering at the University of Michigan and co-corresponding author of the study. “Currently, patients are often presented with treatment options without adequate information regarding which choice may be most effective based on their individual risk factors.”

The researchers developed a device called the “labyrinth chip” that separates cancer cells from blood samples. This allows them to analyze genetic markers in these circulating tumor cells (CTCs). In their recent study, they used this technology to collect CTCs from 34 DCIS patients treated at the University of Kansas Medical Center.

“Our goal is to identify biomarkers that distinguish patients who would benefit from aggressive interventions, including surgery, radiation, and anti-hormonal therapy, from those who may require only surgery or could safely forgo treatment,” said Fariba Behbod, professor at the University of Kansas Medical Center and co-corresponding author.

The team found that certain types of CTCs had genes linked to disease progression and chemotherapy resistance. They also observed differences between Black and white participants; Black patients tended to have more circulating cancer cells and signs of greater immune suppression—factors that align with higher mortality rates among Black women with breast cancer. The researchers noted that these differences likely stem from environmental rather than biological causes.

“That helps us narrow down what could have been indicative that these cells would circulate,” said Neha Nagpal, a doctoral student at U-M and first author on the paper.

Future research will focus on tracking how these cell types behave when transplanted into mice and monitoring both animal models and human patients over time.

Funding for this research came from several sources including the U-M Forbes Institute for Cancer Discovery and Kansas-based institutions. The labyrinth chip was built at the Lurie Nanofabrication Facility at U-M. RNA sequencing was performed at U-M’s Advanced Genomics Core. Bloodscan Biotech—a startup launched through Innovation Partnerships—has licensed the labyrinth chip technology; both Nagrath and U-M hold financial interests in Bloodscan Biotech.

Nagrath also serves as professor of biomedical engineering, co-director of Liquid Biopsy Shared Resources for U-M’s Rogel Cancer Center, and is a member of the U-M Biointerfaces Institute.