Current Approaches and Challenges in Early Detection of Breast Cancer Recurrence

Abstract

Early detection of breast cancer recurrence is a key element of follow-up care and surveillance after completion of primary treatment. The goal is to improve survival by detecting and treating recurrent disease while potentially still curable assuming a more effective salvage surgery and treatment. In this review, we present the current guidelines for early detection of recurrent breast cancer in the adjuvant setting. Emphasis is placed on the multidisciplinary approach from surgery, medical oncology, and radiology with a discussion of the challenges faced within each setting.

Loss of RBMS3 Confers Platinum Resistance in Epithelial Ovarian Cancer via Activation of miR-126-5p/β-catenin/CBP signaling

“…Platinum-based chemotherapy, the cornerstone of modern treatment for EOC, can induce considerable clinical remission. However, most patients with advanced EOC invariably experience relapse and eventually die from this disease (1)(2)(3)(4). In this scenario, understanding the molecular basis of platinum resistance may aid in the stratification of patients with EOC who are most likely to benefit from platinum-based chemotherapy, as well as the delineation of new targets for the pharmacologic intervention of patients with poor outcomes.…”

“…Among the various therapeutic modalities currently used for epithelial ovarian cancer (EOC), cytoreductive surgery combined with platinum-based chemotherapy is still acknowledged to be of the most effective treatments (1,2). Despite the fact that more than 80% of patients with EOC exhibit encouraging initial clinical responses to chemotherapy with platinum-based drugs, the responses are often temporary.…”

c-Met PET Imaging Detects Early-Stage Locoregional Recurrence of Basal-Like Breast Cancer

“…Current surveillance guidelines have been shown to be less effective in the detection of locoregional recurrence than the more expensive, yet more sensitive, approaches such as MRI or radionuclide imaging (SPECT, PET) (13,14). It is believed that either individually or as a companion test for established diagnostic approaches, targeted molecular imaging of specific tumor markers bears the potential to positively change BC follow-up, especially in patients presenting with a high risk of relapse, such as BLBC patients (20,21).…”

“…MRI and 18 F-FDG PET/CT offer a comparably higher sensitivity and specificity for detection and characterization of BC relapse (14). However, differentiation of recurrent BC from inflammatory or infectious processes and the identification of small lesions (tumor size , 20 mm) still impose challenges for 18 F-FDG PET (15,16).…”

Clinical Surveillance Compared with Clinical and Magnetic Resonance Imaging Surveillance for Brain Metastasis: A Feasibility Survey

“…The current literature also demonstrates that mri surveillance can negatively affect a patient's qol. Schneble et al 5 emphasized that surveillance techniques should not only strive for improved patient survival, but also attend to the patient's qol; the implementation of unnecessary interventions can result in increased patient anxiety, needless testing, and increased cost of care and utilization of resources. I am worried that participating in the experimental arm (only clinical follow-up and not the radiological follow-up) would compromise my health.…”