This book provides readers with the most up-to-date practical information on breast cancer screening. Since breast cancers are highly heterogeneous, time to clinical onset from the initial carcinogenesis differs diversely between cancers. Pathological germline variants and driver mutations cause a high lifetime risk of breast cancer. The lifetime risks are various according to what genes are pathologically dysfunctional. Integrated omics and imaging technologies have established varying tumour characteristics. Thus, this book suggests that a more individualised scheme is required to improve breast cancer screening.
A key aim is to demonstrate how multiple diagnostic imaging modalities such as mammography, ultrasonography, MRI, PET and dbPET improve breast cancer screening accuracy. Mammography screening alone may have a limited impact on breast cancer risk prediction. These issues are crucial to discuss. Clinical experts recommend that new modalities be incorporated for women with dense breasts, like ultrasonography, dynamic mammography, MRI and maybe breast-dedicated PET. Topics on these modalities are going to be summarized in this book. An in-depth review of these modalities is summarised in this book. In addition, new diagnostic modalities, including risk assessment tools, multi-cancer early detection tests using liquid biopsy, the role of protein biomarkers in breast cancer risk screening, challenges, and hopes for future advances, are also covered in this book.
Author(s): Masakazu Toi
Publisher: Springer
Year: 2023
Language: English
Pages: 190
City: Singapore
Foreword
Preface
Acknowledgements
Contents
Advances in Breast Cancer Screening: Precision, Imaging, and Harms
Epidemiology
Precision Medicine, Fine Staging, Precise Prediction of Prognosis, and Escalation/De-escalation in Treatment
Screen-Detected Breast Cancer
DCIS
AGE Issues
Dense Breasts
Digital Breast Tomosynthesis (DBT)
Ultrasound, MRI, and PET for Screening
Harms
Biology of Interval Cancers
Conclusion
References
Breast Cancer Risk Assessment Models and Multi-Cancer Early Detection Tests
Risk Assessment Tools (RATs)
Validation of RATs
Polygenic Risk Score in Breast Cancer Risk Assessment
Tumor Growth and Early Detection
RATs and Clinical Trials
Blood Tests and Multi-Cancer Early Detection
MCEDs and Clinical Trials
Conclusion
References
Hereditary Breast Cancer and Pathogenic Germline Variants
Introduction
Pathogenic Germline Variants and Incidence
Germline Variants and Cancer Occurrence
Germline Variants on Cancer Pathogenesis
PGVs and Somatic Abnormalities
PGV and Chemotherapy Sensitivity
PARP Inhibitors for BC Patients Carrying PGVs
PGVs, Prognosis and Survival Prediction, Role in BC Immune Microenvironment
Conclusion
References
Over-Diagnosis and Breast Cancer Screening
Introduction
Trials of Breast Cancer Screening
Ductal Carcinoma In Situ
Evidence for Over-Diagnosis
Harms of Breast Cancer Screening
Assessing the Efficacy of Breast Screening Modalities
Conclusions
References
Breast Cancer Screening with MRI in Women with Over 20% Lifetime Risk
Introduction: Can Screening Reduce Mortality in Women with Increased Breast Cancer Risk?
Methods and Results of the Randomized FaMRIsc and DENSE MRI-Screening Trials in Women with ≥20% Lifetime BC Risk
Cost-Effectiveness of MRI-Screening for ≥20% BC Risk
Preference of High-Risk Women for MRI
Discussion
References
MRI for Breast Cancer Screening: Technical Consideration
Introduction
Abbreviated Breast MRI
Ultrafast Dynamic Contrast-Enhanced (UF-DCE) MRI
Unenhanced MRI Including Diffusion-Weighted Imaging (DWI)
Feasibility of Breast MRI Screening
Conclusion
References
Risk-Reducing Surgery for Breast Cancer
Introduction
Risk Factors for Breast Cancer
High-Risk Predisposing Genes
Low/Intermediate-Risk Predisposing Genes
Genetic Testing and Risk Prediction
Management Options for Women with High-Penetrance Mutations
Risk-Reducing Surgery for Women with High-Penetrance Gene Mutations
Contralateral Prophylactic Mastectomy in Mutation Carriers
Surgical Techniques
Conclusion
References
Cost-Effectiveness of Genetic Testing Strategies for Breast Cancer
Genetic Susceptibility in Breast Cancer
Current Strategy of Genetic Testing and Its Limitations
Clinical Benefits of Genetic Testing in Women with BC
Routine Genetic Testing at Breast Cancer Diagnosis
Cost-Effectiveness of Routine Genetic Testing at Breast Cancer Diagnosis
Clinical Criteria or FH-Based Testing at BC Diagnosis
Genetic Testing for All at BC Diagnosis
Barriers and Solutions for Implementing Increased Testing
Population-Based Genetic Testing
Cost-Effectiveness of Population-Based Genetic Testing
BRCA Testing in the Jewish Population
CSG Testing in the Non-Jewish General Population
Conclusion
References
Biomarkers in Proteomics
Development of Proteomics
Methods of Clinical Proteomics
Discovering Biomarker Candidates in Proteomics
Proteomics Application in Clinic
Future Biomarker Science
References
Ultrasound in Breast Cancer Screening
Introduction
Breast Ultrasound Screening Trials
Ultrasound Screening for High-Risk Women
Evaluation of Adjunctive Ultrasound Screening with Varying Breast Density
Simultaneous Interpretation of US and MG for a Decrease in Recall Rate
Future Directions of Ultrasound Breast Cancer Screening (On-Going Trial)
Conclusions
References
Detection of Breast Cancer by PET
Introduction
Types of High-Resolution Breast PET Systems and Examination Protocols
Interpretive Criteria: Lexicon
Detection of Cancers with Breast PET
Breast Cancer Screening Using PET and Breast PET
Summary
References
Inverse Scattering Problem and Microwave Mammography
Clinical Research
Conclusion
References
Photoacoustic Imaging of Breast Cancer
Introduction
Principle of Photoacoustic Imaging
Application of Photoacoustic Imaging to Breast Cancer
Future Directions
Conclusion
References
Japanese Breast Cancer Screening: Challenges and Hopes
Twenty Years of Mammography Screening
Current Challenges
References
