Innovations and Challenges in Breast Cancer Care: A Review
Abstract
1. Introduction
2. Materials and Methods
3. Results and Discussions—Innovations in Breast Cancer Care
3.1. Diagnostic Innovations in Breast Imaging
3.1.1. Mammography
3.1.2. Ultrasound Elastography
3.1.3. Newer Ultrasound Localization Techniques
3.1.4. Outpatient Vacuum-Assisted Biopsy and Excision of Breast lesions (VAB/VAE)
3.2. Diagnostic Pathology Innovations
3.2.1. Gene Profiling of Breast Cancer
3.2.2. HER2 Receptor Profiling
3.3. Management
3.3.1. Role of Oncoplastic Multidisciplinary Team Meeting (MDT)
3.3.2. Breast Implant Registry
3.3.3. Surgical Considerations
3.3.4. Oncological Considerations
Radiotherapy
Chemotherapy and Pre-optimization Exercise Prescription
Chemotherapy and Immunotherapy
3.4. Future of Breast Cancer Treatment
3.4.1. Role of Artificial Intelligence (AI)
3.4.2. Breast Cancer Vaccines
3.4.3. Role of Alternative Treatment Methods
3.4.4. Role of Ki67 Marker
3.4.5. Role of Pathological Biomarker in Breast Cancer
3.4.6. Proton Therapy in Breast Cancer
3.5. Challenges
4. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
- Breast Cancer UK. Available online: https://www.breastcanceruk.org.uk/about-breast-cancer/facts-figures-and-qas/facts-and-figures/ (accessed on 10 March 2023).
- Vidya, R.; Leff, D.R.; Green, M.; McIntosh, A.S.; John, E.S.; Kirwan, C.C.; Romics, L.; I Cutress, R.; Potter, S.; Carmichael, A.; et al. Innovations for the future of breast surgery. Br. J. Surg. 2021, 108, 908–916. [Google Scholar] [CrossRef]
- Soh, C.L.; Shah, V.; Rad, A.A.; Vardanyan, R.; Zubarevich, A.; Torabi, S.; Weymann, A.; Miller, G.; Malawana, J. Present and future of machine learning in breast surgery: Systematic review. Br. J. Surg. 2022, 109, 1053–1062. [Google Scholar] [CrossRef] [PubMed]
- Romeo, V.; Accardo, G.; Perillo, T.; Basso, L.; Garbino, N.; Nicolai, E.; Maurea, S.; Salvatore, M. Assessment and Prediction of Response to Neoadjuvant Chemotherapy in Breast Cancer: A Comparison of Imaging Modalities and Future Perspectives. Cancers 2021, 13, 3521. [Google Scholar] [CrossRef] [PubMed]
- Forrest, A.P.M. Breast Cancer Screening: Report to the Health Ministers of England, Wales, Scotland and Northern Ireland; HMSO: London, UK, 1986.
- Kulkarni, S.; Freitas, V.; Muradali, D. Digital Breast Tomosynthesis: Potential Benefits in Routine Clinical Practice. Can. Assoc. Radiol. J. 2022, 73, 107–120. [Google Scholar] [CrossRef]
- Jochelson, M.S.; Lobbes, M.B.I. Contrast-enhanced Mammography: State of the Art. Radiology 2021, 299, 36–48. [Google Scholar] [CrossRef] [PubMed]
- Barr, R.G. The Role of Sonoelastography in Breast Lesions. Semin. Ultrasound CT MRI 2018, 39, 98–105. [Google Scholar] [CrossRef]
- Shiina, T.; Nightingale, K.R.; Palmeri, M.L.; Hall, T.J.; Bamber, J.C.; Barr, R.G.; Castera, L.; Choi, B.I.; Chou, Y.-H.; Cosgrove, D.; et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology. Ultrasound Med. Biol. 2015, 41, 1126–1147. [Google Scholar] [CrossRef][Green Version]
- Kabeer, K.K.; Gowda, S.M.; Mohd-Isa, Z.; Thomas, M.J.R.; Gopalan, V.; Jafferbhoy, S.; Soumian, S.; Narayanan, S.; Kirby, R.; Marla, S. An Audit on Oncological Safety with Magseed Localised Breast Conserving Surgery. Indian J. Surg. Oncol. 2022, 13, 616–621. [Google Scholar] [CrossRef]
- Davey, M.G.; O’Donnell, J.P.M.; Boland, M.R.; Ryan, É.J.; Walsh, S.R.; Kerin, M.J.; Lowery, A.J. Optimal localisation strategies for non-palpable breast cancers—A network meta-analysis of randomised controlled trials. Breast 2022, 62, 103–113. [Google Scholar] [CrossRef]
- Kasem, I.; Mokbel, K. Savi Scout® Radar Localisation of Non-palpable Breast Lesions: Systematic Review and Pooled Analysis of 842 Cases. Anticancer Res. 2020, 40, 3633–3643. [Google Scholar] [CrossRef]
- Dave, R.V.; Barrett, E.; Morgan, J.; Chandarana, M.; Elgammal, S.; Barnes, N.; Sami, A.; Masudi, T.; Down, S.; Holcombe, C.; et al. Wire- and magnetic-seed-guided localisation of impalpable breast lesions: iBRA-NET localisation study. Br. J. Surg. 2022, 109, 274–282. [Google Scholar] [CrossRef] [PubMed]
- Hoon Tan, P.; Ellis, I.; Allison, K.; Brogi, E.; Fox, S.B.; Lakhani, S.; Lazar, A.J.; Morris, E.A.; Sahin, A.; Salgado, R.; et al. The 2019 World Health Organization classification of tumours of the breast. Histopathology 2020, 77, 181–185. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Rageth, C.J.; O’flynn, E.A.M.; Pinker, K.; Kubik-Huch, R.A.; Mundinger, A.; Decker, T.; Tausch, C.; Dammann, F.; Baltzer, P.A.; Fallenberg, E.M.; et al. Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions). Breast Cancer Res. Treat. 2019, 174, 279–296. [Google Scholar] [CrossRef] [PubMed][Green Version]
- O’Flynn, E.A.; Wilson, A.R.; Michell, M.J. Image-guided breast biopsy: State-of-the-art. Clin. Radiol. 2010, 65, 259–270. [Google Scholar] [CrossRef]
- McMahon, M.A.; Haigh, I.; Chen, Y.; Millican-Slater, R.A.; Sharma, N. Role of vacuum assisted excision in minimising overtreatment of ductal atypias. Eur. J. Radiol. 2020, 131, 109258. [Google Scholar] [CrossRef]
- Bianchi, S.; Caini, S.; Renne, G.; Cassano, E.; Ambrogetti, D.; Cattani, M.G.; Saguatti, G.; Chiaramondia, M.; Bellotti, E.; Bottiglieri, R.; et al. Positive predictive value for malignancy on surgical excision of breast lesions of uncertain malignant potential (B3) diagnosed by stereotactic vacuum-assisted needle core biopsy (VANCB): A large multi-institutional study in Italy. Breast 2011, 20, 264–270. [Google Scholar] [CrossRef]
- Prat, A.; Pineda, E.; Adamo, B.; Galván, P.; Fernández, A.; Gaba, L.; Díez, M.; Viladot, M.; Arance, A.; Muñoz, M. Clinical implications of the intrinsic molecular subtypes of breast cancer. Breast 2015, 24 (Suppl. S2), S26–S35. [Google Scholar] [CrossRef][Green Version]
- Martínez-Sáez, O.; Prat, A. Current and Future Management of HER2-Positive Metastatic Breast Cancer. JCO Oncol. Pract. 2021, 17, 594–604. [Google Scholar] [CrossRef]
- Romond, E.H.; Perez, E.A.; Bryant, J.; Suman, V.J.; Geyer, C.E., Jr.; Davidson, N.E.; Tan-Chiu, E.; Martino, S.; Paik, S.; Kaufman, P.A.; et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N. Engl. J. Med. 2005, 353, 1673–1684. [Google Scholar] [CrossRef][Green Version]
- Baselga, J.; Swain, S.M. CLEOPATRA: A phase III evaluation of pertuzumab and trastuzumab for HER2-positive metastatic breast cancer. Clin. Breast Cancer 2010, 10, 489–491. [Google Scholar] [CrossRef]
- Verma, S.; Miles, D.; Gianni, L.; Krop, I.E.; Welslau, M.; Baselga, J.; Pegram, M.; Oh, D.-Y.; Diéras, V.; Guardino, E.; et al. Trastuzumab emtansine for HER2-positive advanced breast cancer. N. Engl. J. Med. 2012, 367, 1783–1791. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Krop, I.E.; Kim, S.B.; González-Martín, A.; LoRusso, P.M.; Ferrero, J.M.; Smitt, M.; Yu, R.; Leung, A.C.; Wildiers, H.; TH3RESA study collaborators. Trastuzumab emtansine versus treatment of physician’s choice for pretreated HER2-positive advanced breast cancer (TH3RESA): A randomised, open-label, phase 3 trial. Lancet Oncol. 2014, 15, 689–699. [Google Scholar] [CrossRef] [PubMed]
- Gilmour, A.; Cutress, R.; Gandhi, A.; Harcourt, D.; Little, K.; Mansell, J.; Murphy, J.; Pennery, E.; Tillett, R.; Vidya, R.; et al. Oncoplastic breast surgery: A guide to good practice. Eur. J. Surg. Oncol. 2021, 47, 2272–2285. [Google Scholar] [CrossRef] [PubMed]
- MacNeill, F.; Tasoulis, M.K.; Tan, M.L.H.; Karakatsanis, A. The Breast and Oncoplastic Multidisciplinary Team. In Breast Cancer Management for Surgeons; Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E., Eds.; Springer: Cham, Switzerland, 2018. [Google Scholar] [CrossRef][Green Version]
- Keogh. Poly Implant Prothèse (PIP) Breast Implants: Final Report of the Expert Group. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/192028/Review_of_the_Regulation_of_Cosmetic_Interventions.pdf (accessed on 6 April 2023).
- Breast and Cosmetic Implant Registry (BCIR). Available online: https://digital.nhs.uk/data-and-information/clinical-audits-and-registries/breast-and-cosmetic-implant-registry (accessed on 6 April 2023).
- Offodile, A.C., 2nd; Gu, C.; Boukovalas, S.; Coroneos, C.J.; Chatterjee, A.; Largo, R.D.; Butler, C. Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: Systematic review and meta-analysis of the literature. Breast Cancer Res. Treat. 2019, 173, 65–77. [Google Scholar] [CrossRef] [PubMed]
- Batdorf, N.J.; Lemaine, V.; Lovely, J.K.; Ballman, K.V.; Goede, W.J.; Martinez-Jorge, J.; Booth-Kowalczyk, A.L.; Grubbs, P.L.; Bungum, L.D.; Saint-Cyr, M. Enhanced recovery after surgery in microvascular breast reconstruction. J. Plast. Reconstr. Aesthetic Surg. 2015, 68, 395–402. [Google Scholar] [CrossRef]
- McCulley, S.J.; Schaverien, M.V.; Tan, V.K.; Macmillan, R.D. Lateral thoracic artery perforator (LTAP) flap in partial breast reconstruction. J. Plast. Reconstr. Aesthetic Surg. 2015, 68, 686–691. [Google Scholar] [CrossRef]
- Hamdi, M.; Van Landuyt, K.; Monstrey, S.; Blondeel, P. Pedicled perforator flaps in breast reconstruction: A new concept. Br. J. Plast. Surg. 2004, 57, 531–539. [Google Scholar] [CrossRef]
- Chopra, S.; Rehnke, R.D.; Vidya, R. Implant-based Prepectoral Breast Reconstruction: The Importance of Oncoplastic Plane, its Blood Supply and Assessment Methods. World J. Plast. Surg. 2021, 10, 108–113. [Google Scholar] [CrossRef]
- Chopra, S.; Al-Ishaq, Z.; Vidya, R. The Journey of Prepectoral Breast Reconstruction through Time. World J. Plast. Surg. 2021, 10, 3–13. [Google Scholar] [CrossRef]
- Nelson, J.A.M.; Dabic, S.M.; Mehrara, B.J.; Cordeiro, P.G.; Disa, J.J.; Pusic, A.L.M.; Matros, E.M.; Dayan, J.H.; Allen, R.J.J.; Coriddi, M.; et al. Breast Implant-associated Anaplastic Large Cell Lymphoma Incidence: Determining an Accurate Risk. Ann. Surg. 2020, 272, 403–409. [Google Scholar] [CrossRef]
- Kaplan, J.; Rohrich, R. Breast implant illness: A topic in review. Gland. Surg. 2021, 10, 430–443. [Google Scholar] [CrossRef]
- Barr, S.; Topps, A.; Barnes, N.; Henderson, J.; Hignett, S.; Teasdale, R.; McKenna, A.; Harvey, J.; Kirwan, C. Infection prevention in breast implant surgery-A review of the surgical evidence, guidelines and a checklist. Eur. J. Surg. Oncol. 2016, 42, 591–603. [Google Scholar] [CrossRef]
- Murray Brunt, A.; Haviland, J.S.; Wheatley, D.A.; Sydenham, M.A.; Alhasso, A.; Bloomfield, D.J.; Chan, C.; Churn, M.; Cleator, S.; Coles, C.E.; et al. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. Lancet 2020, 395, 1613–1626. [Google Scholar] [CrossRef]
- Cannioto, R.; Hutson, A.; Dighe, S.; McCann, W.; E McCann, S.; Zirpoli, G.R.; Barlow, W.; Kelly, K.M.; A DeNysschen, C.; Hershman, D.L.; et al. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival. J. Natl. Cancer Inst. 2021, 113, 54–63. [Google Scholar] [CrossRef] [PubMed]
- Ibrahim, E.M.; Al-Homaidh, A. Physical activity and survival after breast cancer diagnosis: Meta-analysis of published studies. Med. Oncol. 2021, 28, 753–765. [Google Scholar] [CrossRef] [PubMed]
- Miglietta, F.; Cona, M.S.; Dieci, M.V.; Guarneri, V.; La Verde, N. An overview of immune checkpoint inhibitors in breast cancer. Explor. Target. Antitumor Ther. 2020, 1, 452–472. [Google Scholar] [CrossRef] [PubMed]
- Cardoso, F.; Senkus, E.; Costa, A.; Papadopoulos, E.; Aapro, M.; André, F.; Harbeck, N.; Aguilar Lopez, B.; Barrios, C.H.; Bergh, J.; et al. 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†. Ann. Oncol. 2018, 29, 1634–1657. [Google Scholar] [CrossRef]
- Leeds Teaching Hospitals Trials AI Software in Breast Cancer Screening. Available online: https://www.digitalhealth.net/2023/03/leeds-teaching-hospitals-trials-ai-software-in-breast-cancer-screening/ (accessed on 6 April 2023).
- Morgan, M.B.; Mates, J.L. Applications of Artificial Intelligence in Breast Imaging. Radiol. Clin. N. Am. 2021, 59, 139–148. [Google Scholar] [CrossRef]
- Ibrahim, A.; Gamble, P.; Jaroensri, R.; Abdelsamea, M.M.; Mermel, C.H.; Chen, P.C.; Rakha, E.A. Artificial intelligence in digital breast pathology: Techniques and applications. Breast 2020, 49, 267–273. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Zhu, S.Y.; Yu, K.D. Breast Cancer Vaccines: Disappointing or Promising? Front. Immunol. 2022, 13, 828386. [Google Scholar] [CrossRef] [PubMed]
- Zhou, W.; Yu, M.; Pan, H.; Qiu, W.; Wang, H.; Qian, M.; Che, N.; Zhang, K.; Mao, X.; Li, L.; et al. Microwave ablation induces Th1-type immune response with activation of ICOS pathway in early-stage breast cancer. J. Immunother. Cancer. 2021, 9, e002343. [Google Scholar] [CrossRef] [PubMed]
- Palussiere, J.; Henriques, C.; Mauriac, L.; Asad-Syed, M.; Valentin, F.; Brouste, V.; Mathoulin-Pélissier, S.; De Lara, C.T.; Debled, M. Radiofrequency ablation as a substitute for surgery in elderly patients with nonresected breast cancer: Pilot study with long-term outcomes. Radiology 2012, 264, 597–605. [Google Scholar] [CrossRef] [PubMed]
- Cazzato, R.L.; De Lara, C.T.; Buy, X.; Ferron, S.; Hurtevent, G.; Fournier, M.; Debled, M.; Palussière, J. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients. Cardiovasc. Interv. Radiol. 2015, 38, 1237–1243. [Google Scholar] [CrossRef] [PubMed]
- Smith, I.E.; Dowsett, M.; Ebbs, S.R.; Dixon, J.M.; Skene, A.; Blohmer, J.-U.; Ashley, S.E.; Francis, S.; Boeddinghaus, I.; Walsh, G. Neoadjuvant Treatment of Postmenopausal Breast Cancer With Anastrozole, Tamoxifen, or Both in Combination: The Immediate Preoperative Anastrozole, Tamoxifen, or Combined With Tamoxifen (IMPACT) Multicenter Double-Blind Randomized Trial. J. Clin. Oncol. 2005, 23, 5108–5116. [Google Scholar] [CrossRef] [PubMed]
- Ellis, M.J.; Miller, W.R.; Tao, Y.; Evans, D.B.; Ross, H.A.C.; Miki, Y.; Suzuki, T.; Sasano, H. Aromatase Expression and Outcomes in the P024 Neoadjuvant Endocrine Therapy Trial. Breast Cancer Res. Treat. 2009, 116, 371–378. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Dowsett, M.; Smith, I.E.; Ebbs, S.R.; Dixon, J.M.; Skene, A.; Griffith, C.; Boeddinghaus, I.; Salter, J.; Detre, S.; Hills, M.; et al. Short-Term Changes in Ki-67 During Neoadjuvant Treatment of Primary Breast Cancer With Anastrozole or Tamoxifen Alone or Combined Correlate With Recurrence-Free Survival. Clin. Cancer Res. An. Off. J. Am. Assoc. Cancer Res. 2005, 11, 951s–958s. [Google Scholar] [CrossRef]
- Lloyd, M.C.; Allam-Nandyala, P.; Purohit, C.N.; Burke, N.; Coppola, D.; Bui, M.M. Using image analysis as a tool for assessment of prognostic and predictive biomarkers for breast cancer: How reliable is it? J. Pathol. Inform. 2010, 1, 29. [Google Scholar] [CrossRef]
- Allison, K.H. Prognostic and predictive parameters in breast pathology: A pathologist’s primer. Mod. Pathol. 2021, 34 (Suppl. S1), 94–106. [Google Scholar] [CrossRef]
- Krol, I.; Schwab, F.D.; Carbone, R.; Ritter, M.; Picocci, S.; De Marni, M.L.; Stepien, G.; Franchi, G.M.; Zanardi, A.; Rissoglio, M.D.; et al. Detection of clustered circulating tumour cells in early breast cancer. Br. J. Cancer 2021, 125, 23–27. [Google Scholar] [CrossRef]
- Lin, L.L.; Vennarini, S.; Dimofte, A.; Ravanelli, D.; Shillington, K.; Batra, S.; Tochner, Z.; Both, S.; Freedman, G. Proton beam versus photon beam dose to the heart and left anterior descending artery for left-sided breast cancer. Acta Oncol. 2015, 54, 1032–1039. [Google Scholar] [CrossRef]
- Arthur, D.; Moughan, J.; Kuerer, H.; Haffty, B.; Cuttino, L.; Todor, D.; Simone, N.; Hayes, S.; Woodward, W.; McCormick, B.; et al. NRG Oncology/RTOG 1014: 3-year efficacy report from a Phase II study of repeat breast preserving surgery and 3D conformal partial breast re-irradiation (PBrI) for in-breast recurrence. Int. J. Radiat. Oncol. Biol. Phys. 2016, 96, 941. [Google Scholar] [CrossRef]
- Lievens, Y.; Pijls-Johannesma, M. Health economic controversy and cost-effectiveness of proton therapy. Semin. Radiat. Oncol. 2013, 23, 134–141. [Google Scholar] [CrossRef] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chopra, S.; Khosla, M.; Vidya, R. Innovations and Challenges in Breast Cancer Care: A Review. Medicina 2023, 59, 957. https://doi.org/10.3390/medicina59050957
Chopra S, Khosla M, Vidya R. Innovations and Challenges in Breast Cancer Care: A Review. Medicina. 2023; 59(5):957. https://doi.org/10.3390/medicina59050957
Chicago/Turabian StyleChopra, Sharat, Muskaan Khosla, and Raghavan Vidya. 2023. "Innovations and Challenges in Breast Cancer Care: A Review" Medicina 59, no. 5: 957. https://doi.org/10.3390/medicina59050957
APA StyleChopra, S., Khosla, M., & Vidya, R. (2023). Innovations and Challenges in Breast Cancer Care: A Review. Medicina, 59(5), 957. https://doi.org/10.3390/medicina59050957