Metastatic Breast Cancer: Cytology Diagnosis with Implications for Treatment

Abstract

Breast cancer is among the most frequent malignancies in women worldwide. While early detection and effective treatment provide many women with a cure and prevent their cancer from spreading, metastases to distant sites still occur in around 20% of women suffering from breast cancer. These relapses occur in many forms and locations and are as varied as the primary breast tumors. Metastatic spread makes a cancer incurable and potentially lethal, but new, targeted treatments can offer control of the cancer cells if the features of new targets are unlocked by advanced diagnostic testing. The article offers an overview of the pathomechanisms of metastatic progression and describes the types of metastases, such as hormone-receptor-positive and -negative breast cancers, and HER2-overexpressing or triple-negative types. Once distant metastatic spread occurs, cytology allows a precise diagnosis to confirm the breast origin. Other molecular targets include ESR1 and PIK3CA mutations, MSI, NTRK fusion, PD-L1 expression and others, which can be obtained also from cytology material and used to determine eligibility for emerging targeted therapeutic options. We outline the diagnostic features of metastatic breast cancer in cytology samples, together with validated and emergent biomarkers that may provide new, targeted treatment options.

Impacts of Sociodemographic Factors, Screening, and Organization of Health Services on Breast Cancer Mortality in Brazil: An Ecological Study of 20 Years

“…In this intricate milieu, the tenets of biopsy and the subsequent pathology diagnosis converge, wielding the prowess to illuminate tumor-staging nuances [ 12 ]. Concomitantly, the efficacy of breast cytology unfolds as a potent diagnostic ally, extending its reach towards both neoplastic and nonneoplastic breast lesions [ 41 ]. Furthermore, the present study unfurls a revelatory spectacle: an ascending trajectory in the tally of breast cytopathological examinations administered corresponds with a commensurate attenuation in the mortality rate.…”

“…Furthermore, the present study unfurls a revelatory spectacle: an ascending trajectory in the tally of breast cytopathological examinations administered corresponds with a commensurate attenuation in the mortality rate. This intriguing correlation is perhaps underpinned by the pivotal role that cytopathological examinations play in shaping prognostic paradigms and treatment delineations [ 41 ]. Curiously, the discernible surge in biopsy numbers, in contrast, remains unattended by a mirrored reduction in mortality rates.…”

A layered cancer-on-a-chip system for anticancer drug screening and disease modeling

“…17 Ductal breast carcinoma (DCIS, ductal carcinoma in situ ) is the most commonly diagnosed malignancy among women and is highly lethal in the metastatic stage. 18 The crucial role of breast fibroblasts in the formation and development of this cancer has been proven, 19 but there is still no standard treatment regimen. The basic procedure in treating breast cancer is reducing the diseased tissue and chemotherapy.…”