Advanced Approaches to Breast Cancer Classification and Diagnosis

Abstract

The International Agency for Research on Cancer (IARC) has recently reported a 66% increase in the global number of cancer deaths since 1960. In the US alone, about one in eight women is expected to develop invasive breast cancer(s) (breast cancer) at some point in their lifetime. Traditionally, a BC diagnosis includes mammography, ultrasound, and some high-end molecular bioimaging. Unfortunately, these techniques detect BC at a later stage. So early and advanced molecular diagnostic tools are still in demand. In the past decade, various histological and immuno-molecular studies have demonstrated that BC is highly heterogeneous in nature. Its growth pattern, cytological features, and expression of key biomarkers in BC cells including hormonal receptor markers can be utilized to develop advanced diagnostic and therapeutic tools. A cancer cell's progression to malignancy exhibits various vital biomarkers, many of which are still underrepresented in BC diagnosis and treatment. Advances in genetics have also enabled the development of multigene assays to detect genetic heterogeneity in BC. However, thus far, the FDA has approved only four such biomarkers—cancer antigens (CA); CA 15-3, CA 27-29, Human epidermal growth factor receptor 2 (HER2), and circulating tumor cells (CTC) in assessing BC in body fluids. An adequately structured portable-biosensor with its non-invasive and inexpensive point-of-care analysis can quickly detect such biomarkers without significantly compromising its specificity and selectivity. Such advanced techniques are likely to discriminate between BC and a healthy patient by accurately measuring the cell shape, structure, depth, intracellular and extracellular environment, and lipid membrane compositions. Presently, BC treatments include surgery and systemic chemo- and targeted radiation therapy. A biopsied sample is then subjected to various multigene assays to predict the heterogeneity and recurrence score, thus guiding a specific treatment by providing complete information on the BC subtype involved. Thus far, we have seven prognostic multigene signature tests for BC providing a risk profile that can avoid unnecessary treatments in low-risk patients. Many comparative studies on multigene analysis projected the importance of integrating clinicopathological information with genomic-imprint analysis. Current cohort studies such as MINDACT, TAILORx, Trans-aTTOM, and many more, are likely to provide positive impact on long-term patient outcome. This review offers consolidated information on currently available BC diagnosis and treatment options. It further describes advanced biomarkers for the development of state-of-the-art early screening and diagnostic technologies.

Dissecting the Role of N6-Methylandenosine-Related Long Non-coding RNAs Signature in Prognosis and Immune Microenvironment of Breast Cancer

“…With the evolution of high-throughput technologies, we tend to subtype the disease into clinically relevant molecular subtypes, including normal-like, luminal A and B, HER2-enriched, and basallike or more intrinsic subtypes (Ochoa et al, 2020;Morgan et al, 2021). The five clinically molecular subtypes have drastically different treatment selection, prognosis, and tumor biology (Zubair et al, 2020). The purpose of BC molecular subtyping is to design personalized treatment strategies for patients based on the emerging evidence of BC classification and treatment responses (Pashayan et al, 2020).…”

α-Mangostin Nanoparticles Cytotoxicity and Cell Death Modalities in Breast Cancer Cell Lines

“…Luminal A and luminal B represent [ER+|PR+]HER2 (tumors with positive ER or PR and negative HER2) and [ER+|PR+]HER2+ subtypes (tumors with positive ER or PR and positive HER2). Luminal A tumors have higher expression of ER-associated genes and lower expression of proliferative genes than luminal B cancers [ 31 , 32 ]. Luminal B tumors tend to have a higher grade than luminal A tumors.…”

The high methylation level of a novel 151-bp CpG island in the ESR1 gene promoter is associated with a poor breast cancer prognosis

“…Molecules expressed in BC, such as estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2), help to categorize the tumors into five subtypes such as luminal A and B, HER2 enriched, TNBC, or basal-like, and normal-like BC [ 13 ]. ER-negative cases seem to be more aggressive and confer a worse prognosis than ER-positive [ 14 ].…”