A groundbreaking discovery by researchers at the University of California San Diego has unveiled a potential method to forecast the likelihood of early-stage breast cancer spreading. By evaluating the adhesion properties of tumor cells using a specially designed microfluidic device, scientists can now identify patients at higher risk for aggressive cancer progression. This innovative approach could revolutionize personalized treatment strategies, ensuring that high-risk patients receive the most appropriate care. The study, which involved testing tumor samples from various stages of breast cancer, revealed a significant correlation between cell adhesion strength and cancer aggressiveness. The findings were published in Cell Reports on March 5.

In an effort to better understand the behavior of different types of breast cancer, researchers developed a microfluidic device capable of sorting tumor cells based on their adhesive properties. The device works by subjecting cells to varying levels of fluid shear stress, thereby classifying them as either weakly or strongly adherent. During trials, the team observed that cells from more aggressive cancers exhibited weaker adhesion compared to those from less aggressive cases. This pattern was particularly evident in ductal carcinoma in situ (DCIS), an early-stage breast cancer often classified as stage zero. DCIS can remain benign or progress into invasive cancer, making it challenging for clinicians to determine the appropriate course of action.

The significance of this research lies in its potential to improve diagnostic accuracy. Current clinical assessments rely heavily on lesion size and grade, but these factors do not always predict cancer behavior accurately. With the new device, doctors may gain a more reliable metric to assess the risk of metastasis. "We have established that weakly adherent cells are more likely to migrate and invade other tissues," explained Adam Engler, senior author and professor at UC San Diego's Jacobs School of Engineering. "This insight could help us tailor treatments more effectively."

The study also highlights the variability in cell adhesion among patients with the same subtype of cancer. For instance, some DCIS patients had strongly adherent cells, while others showed weak adhesion. This heterogeneity suggests that current diagnostic methods might be underestimating the risk for certain patients. To further validate these findings, the research team plans to monitor DCIS patients over five years to see if adhesion strength correlates with disease progression. If successful, this tool could offer oncologists a powerful means to intervene before metastasis occurs.

This collaborative project underscores the importance of interdisciplinary efforts in advancing medical science. Engler’s bioengineering team worked closely with Anne Wallace’s group at Moores Cancer Center, which provided essential patient samples and support. Funding from the National Institutes of Health (NIH) played a crucial role in developing the device and conducting the clinical trial. "Our partnership with Dr. Wallace and the support from NIH have been instrumental," said Engler. "We are hopeful that this device will enable us to identify high-risk patients early, leading to better outcomes."