Advances in Diagnosis 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 October 2025 | Viewed by 2603

Special Issue Editor


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Guest Editor
Division of Medical Oncology, Institute of Oncology Ljubljana, Faculty of Medicine, University of Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
Interests: genomics; cancer biomarkers; cancer biology; gene expression; tumor biology; chemotherapy; targeted therapy; metastasis

Special Issue Information

Dear Colleagues,

Breast cancer remains the most prevalent malignancy in women and its incidence continues to increase worldwide. In the last decade, meaningful insights into the biology of breast cancer have been achieved, and therefore significant advances in locoregional and systemic treatment have been made.

The latest diagnostic techniques include advanced imaging modalities such as MRI, PET-CT, and ultrasound-guided biopsy. In particular, there is a focus on the role of molecular biomarkers in early detection and personalized medicine. In addition, with the advent of genetic testing, our understanding of the risk of breast cancer has evolved significantly.

Exploring classical clinical–pathological and genomic prognostic parameters can more precisely facilitate in predicting the likelihood of distant disease recurrence and overall survival.

This Special Issue aims to enhance our knowledge regarding the latest advancements in the field of breast cancer diagnosis and prognosis. Original research articles, reviews and other papers are welcome. We look forward to receiving your valuable submissions. 

Dr. Domen Ribnikar
Guest Editor

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Keywords

  • breast cancer
  • gene expression profiling in breast cancer
  • cancer biomarkers
  • tumor biology
  • prediction
  • prognosis
  • systemic treatment

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Published Papers (3 papers)

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15 pages, 1948 KiB  
Article
Comparative Study of AI Modes in Ultrasound Diagnosis of Breast Lesions
by Yu-Ting Hong, Zi-Han Yu and Chen-Pin Chou
Diagnostics 2025, 15(5), 560; https://doi.org/10.3390/diagnostics15050560 - 26 Feb 2025
Cited by 1 | Viewed by 917
Abstract
Objectives: This study evaluated the diagnostic performance of the S-Detect ultrasound system’s three selectable AI modes—high-sensitivity (HSe), high-accuracy (HAc), and high-specificity (HSp)—for breast lesion diagnosis, comparing their performance in a clinical setting. Methods: This retrospective analysis evaluated 260 breast lesions from ultrasound images [...] Read more.
Objectives: This study evaluated the diagnostic performance of the S-Detect ultrasound system’s three selectable AI modes—high-sensitivity (HSe), high-accuracy (HAc), and high-specificity (HSp)—for breast lesion diagnosis, comparing their performance in a clinical setting. Methods: This retrospective analysis evaluated 260 breast lesions from ultrasound images of 232 women (mean age: 50.2 years) using the S-Detect system. Each lesion was analyzed under the HSe, HAc, and HSp modes. The study employed ROC curve analysis to comprehensively compare the diagnostic performance of the AI modes against radiologist diagnoses. Subgroup analyses focused on the age (<45, 45–55, >55 years) and lesion size (<1 cm, 1–2 cm, >2 cm). Results: Among the 260 lesions, 73% were identified as benign and 27% as malignant. Radiologists achieved a sensitivity of 98.6%, specificity of 64.2%, and accuracy of 73.5%. The HSe mode exhibited the highest sensitivity at 95.7%. The HAc mode excelled with the highest accuracy (86.2%) and positive predictive value (71.3%), while the HSp mode had the highest specificity at 95.8%. In the age-based subgroup analyses, the HAc mode consistently showed the highest area under the curve (AUC) across all categories. The HSe mode achieved the highest AUC (0.726) for lesions smaller than 1 cm. In the case of lesions sized 1–2 cm and larger than 2 cm, the HAc mode showed the highest AUCs of 0.906 and 0.776, respectively. Conclusions: The S-Detect HSe mode matches radiologists’ performance. Alternative modes provide sensitivity and specificity adjustments. The patient age and lesion size influence the diagnostic performance across all S-Detect modes. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Prognosis of Breast Cancer)
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13 pages, 2733 KiB  
Article
Radiomic Analysis of Magnetic Resonance Imaging for Breast Cancer with TP53 Mutation: A Single Center Study
by Jung Ho Park, Lyo Min Kwon, Hong Kyu Lee, Taeryool Koo, Yong Joon Suh, Mi Jung Kwon and Ho Young Kim
Diagnostics 2025, 15(4), 428; https://doi.org/10.3390/diagnostics15040428 - 10 Feb 2025
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Abstract
Background: Radiomics is a non-invasive and cost-effective method for predicting the biological characteristics of tumors. In this study, we explored the association between radiomic features derived from magnetic resonance imaging (MRI) and genetic alterations in patients with breast cancer. Methods: We [...] Read more.
Background: Radiomics is a non-invasive and cost-effective method for predicting the biological characteristics of tumors. In this study, we explored the association between radiomic features derived from magnetic resonance imaging (MRI) and genetic alterations in patients with breast cancer. Methods: We reviewed electronic medical records of patients with breast cancer patients with available targeted next-generation sequencing data available between August 2018 and May 2021. Substraction imaging of T1-weighted sequences was utilized. The tumor area on MRI was segmented semi-automatically, based on a seeded region growing algorithm. Radiomic features were extracted using the open-source software 3D slicer (version 5.6.1) with PyRadiomics extension. The association between genetic alterations and radiomic features was examined. Results: In total, 166 patients were included in this study. Among the 50 panel genes analyzed, only TP53 mutations were significantly associated with radiomic features. Compared with TP53 wild-type tumors, TP53 mutations were associated with larger tumor size, advanced stage, negative hormonal receptor status, and HER2 positivity. Tumors with TP53 mutations exhibited higher values for Gray Level Non-Uniformity, Dependence Non-Uniformity, and Run Length Non-Uniformity, and lower values for Sphericity, Low Gray Level Emphasis, and Small Dependence Low Gray Level emphasis compared to TP53 wild-type tumors. Six radiomic features were selected to develop a composite radiomics score. Receiver operating characteristic curve analysis showed an area under the curve of 0.786 (95% confidence interval, 0.719–0.854; p < 0.001). Conclusions: TP53 mutations in breast cancer can be predicted using MRI-derived radiomic analysis. Further research is needed to assess whether radiomics can help guide treatment decisions in clinical practice. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Prognosis of Breast Cancer)
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13 pages, 1231 KiB  
Protocol
Real-World, National Study of Palbociclib in HR+/HER2− Metastatic Breast Cancer: A 2.5-Year Follow-Up PALBO01/2021
by Cristina Marinela Oprean, Larisa Maria Badau, Ramona Petrita, Mircea Dragos Median and Alis Dema
Diagnostics 2025, 15(9), 1173; https://doi.org/10.3390/diagnostics15091173 - 5 May 2025
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Abstract
Background: Palbociclib, when combined with endocrine therapy, represents a valuable treatment option for patients diagnosed with hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) negative advanced breast cancer (BC) or metastatic breast cancer (MBC). Approved in Europe following phase II/III trials, [...] Read more.
Background: Palbociclib, when combined with endocrine therapy, represents a valuable treatment option for patients diagnosed with hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) negative advanced breast cancer (BC) or metastatic breast cancer (MBC). Approved in Europe following phase II/III trials, it became the first CDK4/6 inhibitor used alongside hormone therapy. Available real-world data demonstrate the strong performance of Palbociclib in unselected, heavily pretreated patient groups. Our retrospective, observational, multicenter study, conducted in six Romanian institutions during a follow-up period of 2.5 years, aimed to assess Palbociclib’s safety and effectiveness in clinical practice. Objectives: The primary endpoints included response rate such as overall response rate (ORR), duration of response (DOR), disease control rate (DCR) and best clinical response (BCR), progression free survival (PFS) and overall survival (OS). The secondary objectives focused on treatment duration with aromatase inhibitors (AI) or fulvestrant and subsequent therapies after disease progression. Grade 3/4 adverse events were individually recorded. Exploratory analysis evaluated the potential predictive biomarkers such as Ki67, lower levels of HER2 expression (HER2-low), and histological or luminal subtype. Methods: Approximately 650 patients were planned for inclusion. PFS and OS were analyzed via the Kaplan–Meier method, with median times, 1- and 2-year estimates, and 95% confidence intervals reported. Conclusions: This study supports the integration of clinical trial evidence into real-world settings, enhancing patient selection and treatment personalization. Full article
(This article belongs to the Special Issue Advances in Diagnosis and Prognosis of Breast Cancer)
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