New horizon for breast cancer biomarker discoveries: What might the liquid biopsy of nipple aspirate fluid hold?

Abstract

The existence of cellular, molecular and biochemical heterogeneity of human breast cancers reveals the intricacy of biomarkers complexity, stimulating studies on new approaches (like "liquid biopsies") for the improvements in precision medicine. Breast cancer is recognized as a leading cause of morbidity and mortality worldwide with tumors significantly diverse and containing many types of cells showing different genetic and epigenetic profiles. In this field, the technology of liquid biopsy (applied to a fluid produced by breast gland, named nipple aspirate fluids, NAF) highlights the power of combining basic and clinical research. NAF is the mirror of the entire ductal/alveolar breast tree providing almost complete proteomic profile and a valuable source for biomarker discovery, in non-invasive manner than tissue biopsies. The liquid biopsy technology using NAF may represent the outstanding breakthrough of proteomic cancer research revealing novel diagnostic and prognostic applications. In conjunction to metabolomic and degradome profiling, the use of NAF as liquid biopsy approach will improve the detection of changes in the cellular microenvironment of the breast tumors, understanding molecular and biochemical mechanisms which drive breast tumor initiation, maintenance and progression, and finally enhancing the development of novel drug targets and new treatment strategies.

Nipple aspirate fluid and its use for the early detection of breast cancer

“…Early breast cancers no matter how small diagnosed on mammography currently require treatment in the form of breast conserving surgery followed by adjuvant therapy. Nipple aspirate fluid (NAF) is the local biofluid bathing the ductal system and is thought to represent the micro-environment of a developing beast neoplasm [ 14 , 15 ]. The hope is that the assessment of NAF may enable far earlier detection than is currently possible with conventional diagnostic systems and may guide novel pathways for surveillance, particularly in younger women where mammography plays a limited diagnostic role.…”

Nipple Aspirate Fluid at a Glance

“…He also wrote four reviews summarizing current knowledge about proteins, hormones and aluminum detected in NAF of breast cancer patients compared to healthy controls [ 47 , 102 , 103 , 104 ]. His latest publication was a comment reflecting on the potential of investigating biomarkers in NAF [ 105 ].…”

Liquid Biopsy is Instrumental for 3PM Dimensional Solutions in Cancer Management

“…Besides, malignant ascites as a result of peritoneal dissemination of cancer cells could be a good source of a liquid biopsy sample due to its accessibility, predominantly in gastrointestinal cancers [ 30 ]. Moreover, liquid biopsy concerning breast ductal fluid, breast milk, seminal fluid, cervical and vaginal secretions, and uterine/utero-tubular lavage can improve the management of various genital cancers of men as well as women [ 31 , 32 , 33 , 34 , 35 , 36 ]. Several other liquid biopsy samples including tear fluid, sweat, wound efflux, amniotic fluid or bronchoalveolar and peritoneal lavage can also provide benefits for the patient and healthcare at large [ 7 , 9 , 37 , 38 ].…”