Diagnosis, Prognosis and Management 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: 21 April 2026 | Viewed by 610

Special Issue Editor


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Guest Editor
1. Clinic for General Surgery, University Clinical Center Kragujevac, Kragujevac, Serbia
2. Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
Interests: breast surgery; surgical oncology
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Special Issue Information

Dear Colleagues,

Today, breast cancer is the most commonly diagnosed malignant tumor and one of the leading causes of cancer-related mortality among women. Recent advances in diagnostics and treatment have enabled earlier detection, resulting in improved survival rates. Personalized care, encompassing diagnostic strategies, surgical interventions, systemic treatments, and radiation therapy, is grounded in evidence-based practice and a nuanced understanding of tumor biology. Ongoing efforts are focused on detecting breast cancer at its earliest stages through minimally invasive or non-invasive methods that are also cost-effective. A growing body of research examines both tumor-specific features and individual patient factors that may contribute to the development of malignant breast lesions. Significant strides have been made in diagnosing both premalignant and malignant breast conditions. Innovations in imaging such as 3D mammography, surpassing traditional 2D methods, along with improved patient selection and optimized screening protocols have enhanced early detection. Our understanding of what makes screening effective continues to evolve. Additionally, artificial intelligence is emerging as a powerful tool in both diagnostics and the monitoring of treatment response. Nevertheless, identifying which patients are most likely to benefit from targeted therapies and understanding the mechanisms of drug resistance remain areas of uncertainty. The advent of innovative treatments has enabled the emergence of a trend toward the de-escalation of both breast and axillary surgeries, especially in the post-neoadjuvant setting. Postoperative radiotherapy remains a cornerstone of locoregional control. Today, precise radiation techniques and hypofractionated regimens are widely adopted. However, due to the potential side effects of radiation, identifying radiosensitive patient subgroups is increasingly important, a goal that may be achieved through molecular profiling. Ultimately, personalized diagnostics and therapies are essential for effective breast cancer management. Continued research across all aspects of care is vital to improving patient outcomes and long-term prognosis.

We welcome all manuscripts discussing recent advancements and ongoing challenges in the early detection and personalized management of breast cancer. In particular, we hope to focus on novel imaging modalities, prognosis, molecular profiling, artificial intelligence, and the evolving roles of breast surgery, radiotherapy, systemic medical therapy, including chemotherapy, hormonal therapy, targeted therapy, and immunotherapy.

We look forward to receiving your contributions.

Dr. Marko Spasic
Guest Editor

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Keywords

  • breast cancer
  • diagnostics
  • personalized medicine
  • breast surgery
  • individualized treatment
  • radiotherapy
  • immunotherapy
  • targeted therapy

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Published Papers (2 papers)

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Research

20 pages, 1342 KB  
Article
Diagnostic Correlates of Tumor Biology and Immediate Breast Reconstruction After Mastectomy: Real-World Evidence from a Romanian Cohort
by Iulian Slavu, Raluca Tulin, Alexandru Dogaru, Ileana Dima, Cristina Orlov Slavu, Marius Popescu, Cornelia Nitipir, Daniela-Elena Gheoca Mutu and Adrian Tulin
Diagnostics 2026, 16(1), 31; https://doi.org/10.3390/diagnostics16010031 - 22 Dec 2025
Abstract
Background/Objectives: Tumor biology—particularly HER2 expression, Ki-67 proliferation index, and triple-negative phenotype—has traditionally influenced the timing of breast reconstruction after mastectomy. However, real-world data from Eastern Europe remain limited, and variability in access and clinical practice persists. This study aimed to determine whether [...] Read more.
Background/Objectives: Tumor biology—particularly HER2 expression, Ki-67 proliferation index, and triple-negative phenotype—has traditionally influenced the timing of breast reconstruction after mastectomy. However, real-world data from Eastern Europe remain limited, and variability in access and clinical practice persists. This study aimed to determine whether tumor biology independently predicts the likelihood of immediate breast reconstruction (IBR) in a multidisciplinary tertiary center. Methods: We performed a retrospective cross-sectional analysis of 208 consecutive patients who underwent mastectomy with or without IBR between January 2023 and January 2024. Associations between tumor biology (HER2 status, Ki-67 index, and triple-negative subtype) and IBR were examined using χ2 tests, independent samples t-tests, and multivariate logistic regression adjusting for age, BMI, smoking status, comorbidities, neoadjuvant chemotherapy, pathological tumor size (pT), nodal stage (pN), and surgery type. Statistical significance was set at p < 0.05. Results: IBR was performed in 41.4% of HER2-positive and 41.2% of HER2-negative patients (p = 1.00). Reconstruction rates across Ki-67 quartiles (≤10%, 11–20%, 21–40%, ≥41%) were 50.0%, 37.5%, 34.4%, and 37.5%, respectively (p = 0.58). Triple-negative status was not associated with IBR in multivariate analysis (OR = 0.44, 95% CI 0.08–2.18, p = 0.32). Significant predictors of IBR included younger age (OR = 0.87, 95% CI 0.80–0.93, p < 0.001) and less extensive surgery (OR = 0.23, 95% CI 0.09–0.59, p = 0.002). The mean interval to adjuvant therapy was comparable between IBR (28.7 ± 6.2 days) and non-IBR (27.9 ± 5.8 days) groups (p = 0.34), indicating that reconstruction did not delay systemic treatment. Conclusions: In this real-world Romanian cohort, tumor biology did not significantly influence immediate reconstruction decisions. Age and surgical extent were the main determinants of IBR, suggesting that reconstructive access was guided more by clinical than molecular factors. These findings support the shift toward multidisciplinary, biology-informed, and patient-centered surgical decision-making, in line with current ESMO and NCCN recommendations. Despite limitations—including the retrospective design, single-center setting, incomplete BRCA data, and absence of long-term oncologic outcomes—the study provides novel regional perioperative evidence supporting safe and equitable access to immediate reconstruction across biologic subtypes. Full article
(This article belongs to the Special Issue Diagnosis, Prognosis and Management of Breast Cancer)
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15 pages, 3861 KB  
Article
Segmental Non-Mass Enhancement Features in Breast Magnetic Resonance Imaging: A Multicenter Retrospective Study of Histopathologic Correlations
by Hale Aydin, Cansu Bozkurt, Serhat Hayme, Almila Coskun Bilge, Pelin Seher Oztekin, Aydan Avdan Aslan, Irem Ozcan, Serap Gultekin, Abdulkadir Eren and Irmak Durur Subası
Diagnostics 2025, 15(23), 3084; https://doi.org/10.3390/diagnostics15233084 - 4 Dec 2025
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Abstract
Background/Objectives: Segmental non-mass enhancement (NME) is the breast MRI distribution pattern with the highest positive predictive value (PPV) for malignancy. Despite its diagnostic relevance, its imaging characteristics have rarely been examined in isolation, leaving uncertainty in clinical practice. This multicenter retrospective cohort [...] Read more.
Background/Objectives: Segmental non-mass enhancement (NME) is the breast MRI distribution pattern with the highest positive predictive value (PPV) for malignancy. Despite its diagnostic relevance, its imaging characteristics have rarely been examined in isolation, leaving uncertainty in clinical practice. This multicenter retrospective cohort study aimed to evaluate multiparametric MRI features—including internal enhancement pattern, dynamic contrast-enhanced (DCE) kinetics, and diffusion restriction—in segmental NME to identify malignancy predictors. Methods: This retrospective cohort review included 14,834 breast MRI reports from five institutions (September 2017–February 2024), identifying 103 women (mean age, 44.4 ± 9.9 years) with segmental NME (70 malignant, 33 benign). MRI was performed at 1.5 T or 3 T using standardized protocols. Two breast radiologists, blinded to pathology, assessed internal enhancement, DCE kinetics, diffusion restriction, and short tau inversion recovery (STIR) features according to BI-RADS. Statistical analyses included chi-square/Fisher’s tests and logistic regression. Results: Clustered ring enhancement (CRE) was significantly associated with malignancy (p = 0.004). Fast initial-phase enhancement (p < 0.001) and delayed-phase washout (p = 0.011) also correlated with malignancy. On multivariate analysis, fast initial-phase enhancement remained an independent predictor (odds ratio [OR] = 5.133, p = 0.031), whereas slow enhancement predicted benignity (OR = 0.194, p = 0.020). Histologies included ductal carcinoma in situ, invasive ductal carcinoma, granulomatous mastitis, and benign hyperplastic lesions. Conclusions: This study, focusing exclusively on segmental NME, identifies CRE, fast initial-phase enhancement, and washout kinetics as reliable imaging biomarkers. Incorporating these features into breast MRI interpretation may improve diagnostic accuracy, risk stratification, and management decisions. Full article
(This article belongs to the Special Issue Diagnosis, Prognosis and Management of Breast Cancer)
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