Development of Imaging and Liquid Biomarker Analysis for Breast Cancer Screening: A Review

Breast cancer screening tests could reduce the mortality rates for breast cancer patients. Screening and detection are the keystone of cancer prevention and may significantly minimize the death rates in breast cancer patients for long-term. In this review, we would like to present a comprehensive summary from recent publications of the current development for breast cancer screening, classification of breast cancer based on pathological diagnosis, as well as development of breast cancer detection.

The sources of the articles were collected from research published in the PubMed, NCBI databases and manual searches without time restriction based on review of the title, abstract and full review of the articles, using the keywords “breast cancer”, “diagnostic”, “screening”, “imaging”, “biomarker” and the combination of these terms. The criteria excluded in selecting references were articles that are not written in English, newspapers, and posters.

Of the 146 articles that were selected, there were 103 articles included. Breast cancer screening consists of imaging and pathological assessment such as invasive biopsies of tumor tissue and measurement of biomarkers. The recent development of breast cancer screening utilizing different models and methods like biomarkers were being reviewed. For imaging methods, there are mammography, digital breast tomosynthesis (3D mammography), magnetic resonance imaging (MRI), and ultrasonography. For pathological assessment, there are primary biomarker analysis for breast cancer (estrogen receptor, progesterone receptor, HER2, KI67 index) and liquid biomarker analysis from blood or saliva samples. Additionally, there are some diagnostic kit models for breast cancer screening that were in use such as NanoString nCounter®, MammaTyper®, CellSearch System™, and AdnaTest BreastCancer™.

Each of these methods has its own limitations. Therefore, the development of breast cancer models should be more sensitive, reliable, approachable and less harmful.