Clinical and Translational Applications of Serological and Histopathological Biomarkers in Metastatic Breast Cancer: A Comprehensive Review

Abstract

Breast cancer is one of the most common malignancies worldwide and the most common form of cancer in women. A large proportion of patients begin with localized disease and undergo treatment with curative intent, while another large proportion of patients debuts with disseminated metastatic disease. In the last subgroup of patients, the prognosis in recent years has changed radically, given the existence of different targeted therapies thanks to the discovery of different biomarkers. Serological, histological, and genetic biomarkers have demonstrated their usefulness in the initial diagnosis, in the follow-up to detect relapses, to guide targeted treatment, and to stratify the prognosis of the most aggressive tumors in those with breast cancer. Molecular markers are currently the basis for the diagnosis of metastatic disease, given the wide variety of chemotherapy regions and existing therapies. These markers have been a real revolution in the therapeutic arsenal for breast cancer, and their diagnostic validity allows the classification of tumors with higher rates of relapse, aggressiveness, and mortality. In this sense, the existence of therapies targeting different molecular alterations causes a series of changes in tumor biology that can be assessed throughout the course of the disease to provide information on the underlying pathophysiology of metastatic disease, which allows us to broaden our knowledge of the different mechanisms of tissue invasion. Therefore, the aim of the present article is to review the clinical, diagnostic, predictive, prognostic utility and limitations of the main biomarkers available and under development in metastatic breast cancer.

MicroRNAs Associated with Androgen Receptor and Metastasis in Triple-Negative Breast Cancer

“…Some of these pathways are relevant in altering the response of TNBC to therapy by increasing cell sensitivity or reducing resistance [69]. The notion of miRNAs as biomarkers of TNBC [70][71][72] is still in its infancy. The heterogeneity of the disease, the incomplete annotation of miRNAs, and the variable technologies used for the identification of miRNAs are clear obstacles.…”

Clinicopathological Factors Associated with Oncotype DX Risk Group in Patients with ER+/HER2- Breast Cancer

“…In addition to the pathological factors analyzed in this study, other biomarkers predicting the prognosis of breast cancer have been investigated. Despite differences in study cohorts, previous studies have reported the prognostic value of biomarkers such as BCL2, tumor-infiltrating lymphocytes, specific microRNAs, and circulating tumor cells [ 32 , 33 , 34 , 35 ]. Based on these findings, further studies involving patients with early breast cancer are warranted to apply these biomarkers in clinical practice.…”

Circulating CD3+ CD8+ T lymphocytes as indicators of disease status in patients with early breast cancer

“…Early cancer recurrence biomarkers are crucial. Serum markers, such as carcinoembryonic antigen, cancer antigen 15 − 3, and cancer antigen 27-29 (also known as mucin 1), are common in breast cancer [13], but their diagnostic and prognostic utility is limited due to low sensitivity and speci city. New biomarkers, including CTCs, microRNAs, tumor antigens, and extracellular vesicles, aid monitoring and early detection of recurrence or metastasis [14].…”