How Can Liquid Biopsies Improve Early Detection?
Though breast imaging is the current gold standard for breast cancer detection, there is a strong need for a complementary diagnostic tool to improve upon the limitations of standard-of-care imaging. If we were to combine a blood-based approach with imaging, we would allow for increased accuracy and earlier detection of breast cancer. Earlier detection is directly correlated to increased survival. This would add certainity in the detection paradigm for women with difficult-to-interpret imaging results. A liquid biopsy approach that incorporates multiple classes of protein biomarkers to identify breast cancer based on biochemical changes in a woman's body.
Liquid Biopsies Improve Early Detection of Cancer
A liquid biopsy tool, which relies on detection based on protein biomarkers in the blood, has the power to detect breast cancer in real-time, independent of genetic predisposition. Genetic mutations, such as the well known BRCA1 and BRCA2 mutations can increase a woman’s risk of developing breast cancer or ovarian cancer. BRCA mutations account for roughly 5 percent of all breast cancers, but have significant impact on a woman's lifetime risk for developing the disease.
A liquid biopsy test, not reliant on anatomy alone, could complement imaging in the diagnostic workup of abnormal or difficult-to-interpret imaging results to help streamline patient care. Patients with dense breasts have an increased risk of developing breast cancer, as well as an increased risk for a missed diagnosis. While the use of digital mammography is considered standard, for the 50 percent of women with dense breast tissue, glandular tissue may obscur malignancy. This is due to the fact that distinguishing between healthy and dense breast tissue and cancer is difficult as both appear white on imaging, this is often described as trying to spot a polar bear in a snowstorm. Incorporating a liquid biopsy, into the diagnostic workup, which relies on protein biomarkers to indicate biochemical changes rather than an anatomical view provided by imaging alone, can aid in early detection of breast cancer.
A liquid biopsy tool can provide additional insights into the biochemical changes that occur during breast cancer. With this knowledge, healthcare providers can more accurately detect breast cancer and better identify those who need immediate follow-up. A blood-based approach would also have the power to give BI-RADS 3 patients a definitive diagnosis and potentially avoid unnecessary biopsies. When a patient falls into the “gray zone” of a BI-RADS 3 versus BI-RADS 4A, an additional diagnostic tool, not reliant on imaging results alone could aid in decision making. Though the classification only varies by one percent, the treatment plans vary greatly. BI-RADS 3 patients are given a “watch and wait approach” while, BI-RADS 4 patients are biopsied.
There are very clear limitations to breast imaging that we must contest in order to guarantee that all patients are have breast cancer detected more accurately and as early as possible. We need to add a liquid biopsy tool to the current standard-of-care to allow for detection of breast cancer based on physiology as opposed to anatomy. Innovative technologies in the form of a blood based approach will help imaging detect breast cancer more efficiently and more accurately in more women, increasing the survival rate of the disease.