Molecular Imaging and Precision Medicine in Breast Cancer

Abstract

distributed among women with breast cancer [28-30]. Molecular subtypes are not only associated with different tumor phenotypes but also with distinct variations in response to therapy and patient survival. Accordingly, subtype-based recommendations for sys-temic therapies have now been implemented in clinical practice [28-31]. To match advanced therapeutic strategies in the era of precision medicine, diagnostic tests must be equally multilayered and complex to identify the underlying functional processes of cancer development and progression. However, with conventional imaging methods such as mam-mography, DBT, and sonography, which are qualitative tests that detect morphologic, non-specific tissue changes, the assessment and comprehension of breast cancer in all its diversity is not possible. To overcome these limitations, functional imaging techniques to improve breast cancer diagnosis have been explored. In this context , magnetic resonance imaging (MRI) has emerged as an exceptionally powerful, versatile, and precise imaging technique. MRI is an essential non-invasive technique in breast imaging with multiple established indications, such as pre-operative staging of breast cancer, evaluation of therapy response in patients receiving neoad-juvant treatment, differentiation between scar tissue and tumor recurrence , examination of patients with breast implants, and screening of high-risk patients [1, 5]. Dynamic contrast-enhanced MRI of the breast provides both high-resolution morphologic and functional quantitative information on neovascularity as a tumor-specific feature [32-35]. MRI is the most sensitive exam for the detection of breast cancer in women at any given risk [32-36] and often detects cancers that are occult in mammography, DBT and sonog-raphy [37, 38]. Due to these excellent results specific screening programs for high-risk women that include both annual mammogra-phy and MRI have been developed [32, 39] and there is discussion about screening of women at average of risk cancer with abbreviated MRI protocols [40-42]. In addition to breast cancer detection there is evidence that quantitative dynamic contrast enhanced (DCE)-MRI models are useful in the assessment and prediction of Breast cancer is the most common cancer in women, the 2nd leading cause of female cancer deaths and thus remains a major medical and socioeconomic burden. Medical imaging has always been an integral part in breast cancer care ranging from diagnosis and staging to therapy monitoring and post-therapeutic follow-up [1-5]. Screening mammography has significantly contributed to the detection of breast cancer especially at an early, prognostically favorable stage and mammography has been demonstrated to reduce breast cancer mortality [6-9]. Mammography is relatively inexpensive and widely available. However, its sensitivity is limited, ranging from 70 to 85% [10-12] overall but is significantly reduced to 30-50% in women with dense breasts, which can be attributed to the 'masking effect' of dense breast tissue. This effect is d...

Exploring Tumor Heterogeneity Using PET Imaging: The Big Picture

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Ultra-sensitive Nanoprobe Modified with Tumor Cell Membrane for UCL/MRI/PET Multimodality Precise Imaging of Triple-Negative Breast Cancer

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