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Medicina
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Recent Advances in Diagnosis and Therapy of Gynecologic and Breast...
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Recent Advances in Diagnosis and Therapy of Gynecologic and Breast Cancers

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 31 March 2026 | Viewed by 3570

Special Issue Editors

Prof. Dr. Daniela-Cristina Stefan

E-Mail Website
Guest Editor
Medicine School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: global oncology; cervical cancer; cancer equity
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Laurentiu Simion

E-Mail Website
Guest Editor
1. Medicine School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Surgical Oncology Department I, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, Bucharest, Romania
Interests: oncology; gynecologic cancer; breast cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Vlad Rotaru

E-Mail Website
Guest Editor Assistant
Medicine School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: oncology; gynecologic cancer; breast cancer
Dr. Elena Chitoran

E-Mail Website
Guest Editor Assistant
1. Medicine School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Surgical Oncology Department I, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, Bucharest, Romania
Interests: oncology; gynecologic cancer; breast cancer

Special Issue Information

Dear Colleagues,

Gynecologic cancers, which include ovarian, endometrial, cervical, vulvar, and vaginal cancers, represent a significant burden in women's health worldwide. These malignancies are influenced by a complex interplay of genetic, hormonal, environmental, and lifestyle factors. Advances in our understanding of hereditary syndromes such as BRCA mutations and Lynch syndrome have underscored the importance of genetic predisposition in the development of these cancers, paving the way for more personalized risk assessments and prevention strategies.

In this Special Issue, we invite manuscripts that explore recent developments in identifying biomarkers that offer insights into genetic susceptibility, tumor behavior, and patient outcomes. Contributions on imaging advancements, particularly those aiding in early detection and accurate staging, are also highly encouraged. Novel therapies, including targeted molecular treatments and anti-angiogenetic strategies, are reshaping the therapeutic landscape and provide exciting avenues for improved patient management. Furthermore, given the rapid evolution of immunotherapy, we welcome research detailing innovative immunotherapeutic approaches, such as immune checkpoint inhibitors, which are demonstrating remarkable potential in managing both gynecologic and other solid tumors. In addition to these cutting-edge approaches, we are particularly interested in manuscripts discussing the advancements in radiotherapy and brachytherapy, which remain cornerstones of gynecologic cancer treatment. Improvements in precision radiotherapy techniques, as well as innovations in brachytherapy for cervical and endometrial cancers, are transforming patient outcomes and reducing treatment-related toxicity. Finally, we invite you to discuss advances in surgical resection and lymph node staging.

We also consider breast cancer within the scope of this issue, recognizing its shared genetic, hormonal, and etiological ties with gynecologic cancers. Submissions addressing advances in breast cancer diagnostics and treatments are encouraged, further expanding our collective understanding of cancers that predominantly affect women.

Through this Special Issue, we aim to offer a comprehensive overview of the latest advances in research, diagnosis, and treatment, fostering innovation and enhancing clinical practice in the field of gynecologic oncology.

Prof. Dr. Daniela-Cristina Stefan
Prof. Dr. Laurentiu Simion
Guest Editors

Dr. Vlad Rotaru
Dr. Elena Chitoran
Guest Editor Assistants

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • gynecologic cancer
  • breast cancer
  • biomarkers
  • novel therapies
  • personalized medicine
  • debulking surgery
  • molecular therapies
  • genetic predisposition
  • quality of life
  • patient-reported outcomes

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Published Papers (4 papers)

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Research

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15 pages, 640 KiB  
Article
Interpretable Machine Learning for Serum-Based Metabolomics in Breast Cancer Diagnostics: Insights from Multi-Objective Feature Selection-Driven LightGBM-SHAP Models
by Emek Guldogan, Fatma Hilal Yagin, Hasan Ucuzal, Sarah A. Alzakari, Amel Ali Alhussan and Luca Paolo Ardigò
Medicina 2025, 61(6), 1112; https://doi.org/10.3390/medicina61061112 - 19 Jun 2025
Abstract
Background and Objectives: Breast cancer accounts for 12.5% of all new cancer cases in women worldwide. Early detection significantly improves survival rates, but traditional biomarkers like CA 15-3 and HER2 lack sensitivity and specificity, particularly for early-stage disease. Advances in metabolomics and machine [...] Read more.
Background and Objectives: Breast cancer accounts for 12.5% of all new cancer cases in women worldwide. Early detection significantly improves survival rates, but traditional biomarkers like CA 15-3 and HER2 lack sensitivity and specificity, particularly for early-stage disease. Advances in metabolomics and machine learning, particularly explainable artificial intelligence (XAI), offer new opportunities for identifying robust biomarkers and improving diagnostic accuracy. This study aimed to identify and validate serum-based metabolic biomarkers for breast cancer using advanced metabolomic profiling techniques and a Light Gradient Boosting Machine (LightGBM) model. Additionally, SHapley Additive exPlanations (SHAP) were applied to enhance model interpretability and biological insight. Materials and Methods: The study included 103 breast cancer patients and 31 healthy controls. Serum samples underwent liquid and gas chromatography–time-of-flight mass spectrometry (LC-TOFMS and GC-TOFMS). Mutual Information (MI), Sparse Partial Least Squares (sPLS), Boruta, and Multi-Objective Feature Selection (MOFS) approaches were applied to the data for biomarker discovery. LightGBM, AdaBoost, and Random Forest were employed for classification and to identify class imbalance with the Synthetic Minority Oversampling Technique (SMOTE). SHAP analysis ranked metabolites based on their contribution to model predictions. Results: Compared to other feature selection approaches, the MOFS approach was more robust in terms of predictive performance, and metabolites identified by this method were used in subsequent analyses for biomarker discovery. LightGBM outperformed the AdaBoost and Random Forest models, achieving 86.6% accuracy, 89.1% sensitivity, 84.2% specificity, and an F1-score of 87.0%. SHAP analysis identified 2-Aminobutyric acid, choline, and coproporphyrin as the most influential metabolites, with dysregulation of these markers associated with breast cancer risk. Conclusions: This study is among the first to integrate SHAP explainability with metabolomic profiling, bridging computational predictions and biological insights for improved clinical adoption. This study demonstrates the effectiveness of combining metabolomics with XAI-driven machine learning for breast cancer diagnostics. The identified biomarkers not only improve diagnostic accuracy but also reveal critical metabolic dysregulations associated with disease progression. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Therapy of Gynecologic and Breast Cancers)
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Review

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30 pages, 698 KiB  
Review
Psycho-Oncology in Breast Cancer: Supporting Women Through Distress, Treatment, and Recovery—Three Arguments—Rapid Narrative Review
by Mădălina Daniela Meoded, Mariana Tănase, Claudia Mehedințu and Ciprian Cirimbei
Medicina 2025, 61(6), 1008; https://doi.org/10.3390/medicina61061008 - 28 May 2025
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Abstract
Background and Objectives: Breast cancer remains one of the most prevalent malignancies affecting women and one of the most emotionally distressing diagnoses. Emerging evidence suggests that chronic psychological stress may influence cancer progression via neuroendocrine and immune mechanisms. This rapid narrative review explores [...] Read more.
Background and Objectives: Breast cancer remains one of the most prevalent malignancies affecting women and one of the most emotionally distressing diagnoses. Emerging evidence suggests that chronic psychological stress may influence cancer progression via neuroendocrine and immune mechanisms. This rapid narrative review explores three key arguments for integrating psycho-oncologists into the multidisciplinary care of breast cancer patients: (1) early detection and reduction of psychological distress, (2) improvement of treatment adherence, and (3) enhancement of quality of life through personalized psychological interventions. Materials and Methods: The review was conducted through comprehensive searches in PubMed, Scopus, and Web of Science for peer-reviewed articles published between 2010 and 2025. Inclusion criteria comprised randomized controlled trials, systematic reviews, meta-analyses, and theoretical papers. Of 246 identified articles, 50 met the inclusion criteria. Results: Selected studies show that psycho-oncological interventions—including cognitive–behavioral therapy, mindfulness-based techniques, narrative therapy, and guided imagery—significantly reduce anxiety, depression, and fear of recurrence. These approaches improve adherence to endocrine therapy and chemotherapy, enhance emotional resilience, and promote overall well-being. Also, recent research concepts emphasize the role of psycho-oncologists in encouraging post-traumatic growth and helping patients redefine cancer as an opportunity for transformation. Conclusions: Integrating psycho-oncologists into standard breast cancer care improves psychological and clinical outcomes. By addressing emotional distress, strengthening coping mechanisms, and supporting existential resilience, psycho-oncologists contribute to a holistic, patient-centered model of oncology care. Wider implementation of psycho-oncological services is warranted as a core component of comprehensive cancer management. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Therapy of Gynecologic and Breast Cancers)
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31 pages, 537 KiB  
Review
A Minimally Invasive Treatment Approach for Early-Stage Uterine Cervical Cancer: The Impact of the LACC Trial and a Literature Review
by Elena-Mihaela Vrabie, Mihai-Adrian Eftimie, Irina Balescu, Camelia Diaconu and Nicolae Bacalbasa
Medicina 2025, 61(4), 620; https://doi.org/10.3390/medicina61040620 - 28 Mar 2025
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Abstract
Background and Objectives: Recent studies have supported the non-inferiority of the minimally invasive treatment approach over the open approach. However, they have also underlined its inferiority regarding its oncological results, while preserving the short-term benefits. The direct effects of these results were represented [...] Read more.
Background and Objectives: Recent studies have supported the non-inferiority of the minimally invasive treatment approach over the open approach. However, they have also underlined its inferiority regarding its oncological results, while preserving the short-term benefits. The direct effects of these results were represented by indication changes in international guidelines on the application of minimally invasive surgery for treating early-stage cervical cancer. Material and metods: Herein, a literature review, including studies between 1992 and 2017, was performed. Results: The results show that the studies published during this period supported the non-inferiority of the minimally invasive treatment approach for early-stage cervical cancer compared with the open approach. However, the studies included were unicentric, non-randomized and relied on a reduced number of patients. The results of the Laparoscopic Approach to Cervical Cancer [LACC] trial could not have been considered, since only studies published between 1992 and 2017 were included. This trial firmly supported the advantages of the minimally invasive approach in treating early-stage cervical cancer. The literature published after 2018 highlighted the necessity for new clinical studies, randomized and prospective ones, to cover the defects of this study and to verify (or not) its results. Conclusions: the studies published after 2018 mainly focused on the deficiencies of the LACC trial and also on developing new methods that could improve this surgical technique, thus enhancing the safety of the minimally invasive approach in treating early-stage cervical cancer. However, none of the included studies succeeded to provide enough evidence to oppose the results obtained in the LACC trial. Therefore, in order to clarify the state of this surgical approach, the results of three ongoing randomized clinical trials are expected. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Therapy of Gynecologic and Breast Cancers)
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14 pages, 343 KiB  
Review
Gynecological Insights into Lynch Syndrome—A Comprehensive Review of Cancer Screening and Prevention
by Elena Chitoran, Roxana-Elena Bohiltea, Vlad Rotaru, Cristiana-Elena Durdu, Madalina-Nicoleta Mitroiu and Laurentiu Simion
Medicina 2024, 60(12), 2013; https://doi.org/10.3390/medicina60122013 - 6 Dec 2024
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Abstract
Lynch syndrome, one of the most common genetic syndromes predisposing to cancer, is associated with a series of malignant conditions, among which the most frequent is colorectal cancer, but gynecologic cancers (especially endometrial) are also quite common. Despite the significant progress made in [...] Read more.
Lynch syndrome, one of the most common genetic syndromes predisposing to cancer, is associated with a series of malignant conditions, among which the most frequent is colorectal cancer, but gynecologic cancers (especially endometrial) are also quite common. Despite the significant progress made in understanding this condition over time, there are still aspects in managing this condition that have not demonstrated clear benefits. This article aims to summarize the recommendations of international societies and present the latest developments in managing Lynch syndrome, focusing on gynecologic cancer screening and possible prevention strategies. Advances in genetic testing procedures and discoveries related to the association between oncological pathology frequency and the affected pathogenic variant type will probably lead to personalized medicine focused on the individual patient in the coming years. Although various screening methods for gynecological cancers in patients with Lynch syndrome have been used over time, they have not shown significant survival benefits. This highlights the need for studying and implementing new screening and diagnostic methods, which have been under investigation in recent years and are mentioned in this article. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Therapy of Gynecologic and Breast Cancers)
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