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Diagnostics
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Diagnosis, Treatment, and Prognosis of Breast Cancer
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Diagnosis, Treatment, and Prognosis of Breast Cancer

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 1744

Special Issue Editor

Dr. Marko Buta

E-Mail Website
Guest Editor
1. School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia
2. Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia
Interests: breast cancer; thyroid cancer; melanoma; soft tissue sarcoma; surgical oncology; breast surgery; thyroid surgery

Special Issue Information

Dear Colleagues,

On behalf of the Diagnostics Editorial Team, I am delighted to welcome contributions to the Special Issue “Diagnosis, Treatment, and Prognosis of Breast Cancer”.

Breast cancer remains one of the most prevalent malignancies worldwide and a leading cause of cancer-related mortality among women. In recent years, the landscape of breast cancer diagnosis and management has undergone a remarkable transformation, driven by advances in molecular biology, imaging, systemic therapy, and digital medicine. This Special Issue aims to provide an overview of the current state of and future directions in the diagnosis, treatment, and prognosis of breast cancer.

We invite contributions on the integration of novel diagnostic tools—such as advanced imaging, liquid biopsies, and molecular profiling—into clinical workflows. A special focus will be placed on the role of artificial intelligence (AI) in enhancing early detection, imaging interpretation, and pathology. On the therapeutic front, the rise of targeted agents, immunotherapy, and personalized protocols has significantly improved outcomes, particularly in hormone receptor-positive and HER2-positive cases. However, challenges remain for subtypes with limited treatment options, such as triple-negative breast cancer (TNBC), where novel biomarkers and more effective therapies are urgently needed.

This Special Issue seeks original research articles, case reports, systematic reviews, and expert perspectives that address innovations and ongoing challenges in the following areas:

  • Imaging, pathology, and molecular diagnostics;
  • Integration of AI and digital tools in breast cancer detection and decision-making;
  • Personalized treatment strategies and novel therapeutic agents;
  • Prognostic models and outcome predictors;
  • Management of challenging subtypes, including TNBC;
  • Multidisciplinary approaches to breast cancer care.

Our aim is to highlight emerging approaches that have the potential to improve outcomes and quality of care for all patients with breast cancer.

I look forward to receiving your contributions.

Dr. Marko Buta
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer diagnosis
  • molecular profiling
  • artificial intelligence
  • targeted therapy
  • immunotherapy
  • treatment strategies
  • prognostic markers
  • triple-negative breast cancer

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

22 pages, 11104 KB  
Article
Towards Standardized Language to Describe the Pathological Enhancement of the Nipple in NAC-Infiltrating Breast Tumors: A Retrospective Case Series Study
by Cristiana Boldrini, Silvia Amodeo, Angelica Marra, Micol Bottalico, Roberta Dattoli and Riccardo Manfredi
Diagnostics 2025, 15(17), 2155; https://doi.org/10.3390/diagnostics15172155 - 26 Aug 2025
Viewed by 441
Abstract
Background: The normal pattern of nipple enhancement on magnetic resonance imaging (MRI) is defined based on healthy individuals, as it correlates with the structural anatomy of the nipple–areola complex (NAC). Understanding the normal range of nipple morphology and enhancement on MRI allows radiologists [...] Read more.
Background: The normal pattern of nipple enhancement on magnetic resonance imaging (MRI) is defined based on healthy individuals, as it correlates with the structural anatomy of the nipple–areola complex (NAC). Understanding the normal range of nipple morphology and enhancement on MRI allows radiologists to better identify abnormalities. Some authors have previously detailed the morphology and characteristics of nipple–areola complex enhancement, both in normal and pathologically infiltrating conditions. Our aim is to present a case series involving a population of women with breast cancer infiltrating the NAC, retrospectively evaluated at our institution. Furthermore, based on previously published literature and our own experience, we intend to propose potential standardized language to describe tumor-infiltrating NAC enhancement on MRI and compare it with CT and PET findings. Methods: Our study included 110 breast cancer patients with NAC infiltration, who were referred to our hospital from August 2023 to July 2024. All patients were candidates for neoadjuvant chemotherapy and therefore underwent MRI and CT; 33 of them also underwent PET/CT. We distinguished the MRI enhancement pattern based on morphology and intensity. There were three types of morphology: SLE (superficial linear enhancement) at the skin level, NEZ (non-enhancing area immediately below the SLE), and INE (nipple enhancement below the NEZ but above the nipple base). In INE, the pattern could be linear or patchy. Depending on the intensity, the enhancement could be minimal, mild, moderate, or marked. The enhancement on CT depended on the distribution of pathological tissue in the infiltrated NAC and could be present or absent; it could involve the nipple base, the nipple body, or both. For quantitative analysis, we used the maximum standardized uptake value (SUV) measured in early-stage PET/CT images, obtained by delineating a three-dimensional volume of interest (VOI) on the NAC. Results: In our population, the most represented enhancement pattern was INE (110), while slightly less than half of the patients showed invasion of the NEZ (49). Approximately one quarter of the patients presented linear ductal INE (36), while the majority presented patchy INE (74). On CT and PET/CT, NAC enhancement was detectable in almost all patients (102), mainly involving the base and the body together. Correlation analysis in the following pairs of variables showed a high association, with a Kendall’s tau value greater than 0.7 (p < 0.001): (1) involvement of the NEZ on ce-MR and pattern of nipple involvement on ce-CT (CT score); (2) morphological pattern of INE on ce-MR (INE score) and intensity of INE enhancement on MR; and (3) pattern of nipple involvement on ce-CT (CT score) and intensity of INE enhancement on MR. The calculated mean SUV of pathological NACs on PET/CT for early-stage images was 3.59, while the mean SUV of contralateral normal NACs was 2.12. The calculated mean NAC-SUV ratio was 1.7. Conclusions: Although pathological involvement of the NAC cannot always be assessed in the final surgical specimen due to the effects of neoadjuvant chemotherapy, so the “gold standard” of histological reference is missing, MRI and CT with morphology and enhancement descriptors, and additionally PET/CT with SUV measurement can, in our opinion, provide valuable information on the infiltrated nipple. Standardized language for describing breast tumors infiltrating the NAC is desirable to ensure consistent interpretation across different radiologists. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Breast Cancer)
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18 pages, 1632 KB  
Article
Unveiling the Microbiota: A New Frontier in Breast Cancer Pathogenesis—A Single-Center Preliminary Study
by Rukie Ana Maria Ahmet, Andrei Gabriel Nascu, Georgiana Cristina Camen, Cosmin Vasile Obleaga, Dragos George Popa and Cecil Sorin Mirea
Diagnostics 2025, 15(17), 2147; https://doi.org/10.3390/diagnostics15172147 - 25 Aug 2025
Viewed by 431
Abstract
Background: Breast cancer is the most common malignancy affecting women worldwide and continues to pose significant challenges despite progress in early detection and personalized therapies. While its pathogenesis has traditionally been associated with genetic, hormonal, and environmental factors, recent studies have highlighted the [...] Read more.
Background: Breast cancer is the most common malignancy affecting women worldwide and continues to pose significant challenges despite progress in early detection and personalized therapies. While its pathogenesis has traditionally been associated with genetic, hormonal, and environmental factors, recent studies have highlighted the potential role of dysbiosis—an imbalance in gut and systemic microbiota—in breast cancer development and progression. This article aims to examine the mechanisms through which systemic dysbiosis may contribute to breast cancer risk and explore its therapeutic implications. Methods: This study seeks to analyze and compare the fecal microbiota profiles of breast cancer patients and healthy individuals from a single center in Craiova, Romania, in order to identify microbial signatures linked to breast cancer and BRCA mutation status. Special attention is given to the gut–liver axis and its influence on estrogen circulation, a key factor in hormone-sensitive breast cancers. Results: Evidence suggests that dysbiosis can influence breast cancer progression by promoting chronic inflammation, impairing immune regulation, and altering estrogen metabolism through the gut–liver axis. These effects may contribute to tumor development, immune evasion, and therapeutic resistance. Interventions aimed at restoring microbial balance show promise in preclinical studies for mitigating these effects. Conclusions: Systemic dysbiosis represents a potentially modifiable risk factor in breast cancer. Microbiota profiling may serve as a useful biomarker for risk stratification and therapeutic response. Future research into microbiome-based interventions could offer novel approaches for prevention and treatment in breast cancer care. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Breast Cancer)
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19 pages, 724 KB  
Article
Analyzing the Gaps in Breast Cancer Diagnostics in Poland—A Retrospective Observational Study in the Data Donation Model
by Wojciech Sierocki, Ligia Kornowska, Oliver Slapal, Agata Koska, Gabriela Sierocka, Alicja Dudek, Claudia Dompe, Michał Suchodolski, Przemysław Keczmer and Magdalena Roszak
Diagnostics 2025, 15(17), 2127; https://doi.org/10.3390/diagnostics15172127 - 22 Aug 2025
Viewed by 620
Abstract
Background: Breast cancer is a major health concern in Poland, with significant incidence and mortality rates despite national screening programs. This retrospective study aimed to evaluate critical aspects of breast cancer management, focusing on waiting times, treatment coordination, cancer characteristics, diagnostic testing, and [...] Read more.
Background: Breast cancer is a major health concern in Poland, with significant incidence and mortality rates despite national screening programs. This retrospective study aimed to evaluate critical aspects of breast cancer management, focusing on waiting times, treatment coordination, cancer characteristics, diagnostic testing, and staging. Methods: We retrospectively analyzed 587 medical records of breast cancer patients (585 female, 2 male) collected between March 2023 and June 2024 through a data donation model. Data included tumor characteristics (histological type, grade, stage, biological subtype, receptor status, Ki-67), diagnostic and genetic tests, and timelines of key events in the diagnostic and therapeutic pathways. Results: Although referral to first oncology consult (18 days) and MDT referral/admission to treatment (10 days) met NFZ guidelines, diagnosis to surgery (94 days) and diagnosis to drug treatment (109 days) were significantly delayed. No records showed oncology coordinator assignment or educational material provision. Clinically, invasive carcinoma NST (77%) and early-stage (IA/IIA, 61%) were prevalent, with Luminal B (HER2-negative) being the most common biological subtype. BRCA1/2 testing was common, but Oncotype DX was not. For 314 HR+ HER2- patients, stage IA (44%) was most common, with no BRCA1/2 mutations found. Conclusion: Breast cancer care in the Łódź voivodeship falls short of national guidelines due to long waiting times and poor care coordination, a problem worsened by incomplete data. Improving record-keeping and speeding up diagnostic and treatment pathways are crucial for better breast cancer management in Poland. While patient data donation can help analyze real clinical pathways, data completeness, and consistency remain challenges. Full article
(This article belongs to the Special Issue Diagnosis, Treatment, and Prognosis of Breast Cancer)
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