Detection of Circulating Tumor Cells in Peripheral Blood as a Prognostic Indicator among Sudanese Breast Cancer Patients in Shendi, Sudan

Background: Breast cancer is the most common malignancy among women worldwide and remains a major contributor to cancer-related morbidity and mortality. Circulating tumor cells (CTCs) have emerged as a promising liquid biopsy marker for prognostic assessment. However, data regarding CTC prevalence and clinical relevance among Sudanese breast cancer patients are limited. Objective: To detect CTCs in the peripheral blood of Sudanese breast cancer patients and compare them with healthy controls, and to assess their association with clinicopathological characteristics. Materials and Methods: A cross-sectional study was conducted in Shendi, Sudan, including 30 histologically confirmed breast cancer patients and 30 healthy controls. Buffy coat preparations were processed using 2% glacial acetic acid, followed by smear preparation and Giemsa staining. CTCs were identified microscopically based on morphological criteria. Statistical analysis was performed using chi-square tests. Results: CTCs were detected in 11 of 30 breast cancer patients (36.6%), while none were found among the controls (p < 0.001). No significant associations were observed between CTC positivity and tumor type (p = 0.367), tumor stage (p = 0.332), or age group (p = 0.209), although higher CTC frequencies were noted in advanced stages and older patients. Conclusion: CTCs are detectable using conventional Giemsa staining in a substantial proportion of Sudanese breast cancer patients and may serve as a potential non-invasive prognostic indicator. Larger studies using more sensitive detection methods are recommended to further clarify their clinical value. Keywords: Breast cancer, Circulating tumor cells, CTCs, Giemsa stain, Prognostic marker, Sudan.