Abstract

MicroRNAs have emerged as new diagnostic and therapeutic biomarkers for breast cancer. Herein, we analysed miR-99a-5p expression levels in primary tumours and plasma of breast cancer patients to evaluate its usefulness as a minimally invasive diagnostic biomarker. MiR-99a-5p expression levels were determined by quantitative real-time PCR in three independent cohorts of patients: (I) Discovery cohort: breast cancer tissues (n = 103) and healthy breast tissues (n = 26); (II) Testing cohort: plasma samples from 105 patients and 98 healthy donors; (III) Validation cohort: plasma samples from 89 patients and 85 healthy donors. Our results demonstrated that miR-99a-5p was significantly downregulated in breast cancer tissues compared to healthy breast tissues. Conversely, miR-99a-5p levels were significantly higher in breast cancer patients than in healthy controls in plasma samples from both testing and validation cohorts, and ROC curve analysis revealed that miR-99a-5p has good diagnostic potential even to detect early breast cancer. In conclusion, miR-99a-5p’s deregulated expression distinguished healthy patients from breast cancer patients in two different types of samples (tissues and plasma). Interestingly, expression levels in plasma were significantly lower in healthy controls than in early-stage breast cancer patients. Our findings suggest circulating miR-99a-5p as a novel promising non-invasive biomarker for breast cancer detection.

Highlights

  • Breast cancer (BC) is one of the most common malignant diseases in the world

  • Because BC tumours are very heterogeneous, a tissue biopsy is mandatory to obtain the molecular classification of each tumour, that is based on the expression of several biomarkers, such as estrogen receptor (ER), progesterone receptor (PR), HER2 overexpression, or Ki-67, which determine the treatment choice [4,6,7]

  • This study was divided into three parts: (1) Assessment of miR-99a-5p expression levels in BC and healthy breast tissue; (2) Evaluation of the miR-99a-5p expression levels in plasma of BC patients and healthy controls; (3) Validation of miR-99a-5p expression levels as a diagnostic biomarker for BC (Figure 1)

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Summary

Introduction

Breast cancer (BC) is one of the most common malignant diseases in the world. In 2018, more than 2 million new cases were diagnosed, being the leading cause of cancer-related death in women in over 100 countries [1]. A 100% 5-year survival rate is observed for BC patients diagnosed at stage I, it dramatically decreases to 26% for those diagnosed at stage IV [2,3,4]. New BC effective early-diagnosis methods are urgently needed to reduce its mortality rate. Mammography is still considered the gold-standard method for the detection of BC. The sensitivity and specificity of mammography can be low in young women and women with dense breast tissue [5]. Because BC tumours are very heterogeneous, a tissue biopsy is mandatory to obtain the molecular classification of each tumour, that is based on the expression of several biomarkers, such as estrogen receptor (ER), progesterone receptor (PR), HER2 (human epidermal growth factor receptor 2) overexpression, or Ki-67, which determine the treatment choice [4,6,7]

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