Why the Gold Standard Approach by Mammography Demands Extension by Multiomics? Application of Liquid Biopsy miRNA Profiles to Breast Cancer Disease Management

Abstract

In the global context, the epidemic of breast cancer (BC) is evident for the early 21st century. Evidence shows that national mammography screening programs have sufficiently reduced BC related mortality. Therefore, the great utility of the mammography-based screening is not an issue. However, both false positive and false negative BC diagnosis, excessive biopsies, and irradiation linked to mammography application, as well as sub-optimal mammography-based screening, such as in the case of high-dense breast tissue in young females, altogether increase awareness among the experts regarding the limitations of mammography-based screening. Severe concerns regarding the mammography as the “golden standard” approach demanding complementary tools to cover the evident deficits led the authors to present innovative strategies, which would sufficiently improve the quality of the BC management and services to the patient. Contextually, this article provides insights into mammography deficits and current clinical data demonstrating the great potential of non-invasive diagnostic tools utilizing circulating miRNA profiles as an adjunct to conventional mammography for the population screening and personalization of BC management.

A meta‐analysis of contrast‐enhanced spectral mammography versus MRI in the diagnosis of breast cancer

“…Routine mammography is an easy and convenient procedure, but its sensitivity is low due to radiologically dense epithelial and connective breast tissue including the glands, especially in oriental women . Misdiagnosis frequently occurs due to the overlapping pathological appearance.…”

Pathway Analysis of Selected Circulating miRNAs in Plasma of Breast Cancer Patients: A Preliminary Study

“…Based on our literature review [ 10 ] and our yet unpublished data on breast cancer tissues and circulating miRNA expression, five references [ 13 , 14 , 15 , 16 ] and seven target miRNAs [ 17 , 18 ] detectable in plasma were chosen to examine as the most representative biomarkers in plasma of BC patients and control subjects. The process of miRNA profiling consisted of two phases: pilot testing (Phase 1) and final testing (Phase 2).…”

“…Based on the literature review, specific miRNAs were selected with potentially stable plasma expression (reference miRNAs, e.g., miR-16-5p, miR-103a-3p, miR-191-5p, miR-1228-3p, miR-520d-5p) and target miRNAs (miR-10b-5p, miR-99a-5p, miR-130a-3p, miR-342-3p, miR-484, miR-486-5p, miR-1260a) [ 10 , 17 , 52 , 60 ] with elevated expression in the plasma of cancer patients. The expression level of selected target and reference miRNAs was determined by the miRCURY LNA miRNA PCR system (Qiagen), and the quality of samples was tested by synthetic spike-in oligonucleotides (RNA Spike-in kit, Qiagen).…”

“…A modern procedure currently in the research phase involves the detection of candidate cancer-specific biomarkers non-invasively, in patients’ body fluids. One such method is the detection of microRNAs in the patient’s circulation and this seems to be promising in the improvement of BC screening and in the treatment and monitoring of the disease [ 10 ].…”

Cell-free nucleic acid patterns in disease prediction and monitoring—hype or hope?

“…However, independently of the application area, the main goal remains the same, namely to look for pathology-specific patterns [ 6 – 8 ] as well as for patterns clearly indicating associated risks, for example, in vasospastic individuals who may be particularly predisposed to an increased stress sensitivity [ 9 – 11 ], neuro/degenerative pathologies [ 12 , 13 ] and/or aggressive metastasing cancers [ 14 , 15 ].…”