Abstract
Breast cancer is the most common cancer diagnosed in women. In recent times, survival outcomes have improved dramatically in accordance with our enhanced understanding of the molecular processes driving breast cancer proliferation and development. Refined surgical approaches, combined with novel and targeted treatment options, have aided the personalisation of breast cancer patient care. Despite this, some patients will unfortunately succumb to the disease. In recent times, translational research efforts have been focused on identifying novel biomarkers capable of informing patient outcome; microRNAs (miRNAs) are small non-coding molecules, which regulate gene expression at a post-transcriptional level. Aberrant miRNA expression profiles have been observed in cancer proliferation and development. The measurement and correlation of miRNA expression levels with oncological outcomes such as response to current conventional therapies, and disease recurrence are being investigated. Herein, we outline the clinical utility of miRNA expression profiles in informing breast cancer prognosis, predicting response to treatment strategies as well as their potential as therapeutic targets to enhance treatment modalities in the era of precision oncology.
Highlights
Tumour Heterogeneity and Precision Oncology Breast cancer is the most common cancer in women, with estimations suggesting
We recognise a novel taxonomy of breast cancer which classifies four distinct clinically relevant molecular subtypes, i.e., Luminal A breast cancer (LABC), Luminal B breast cancer (LBBC), human epidermal growth factor Receptor-2-enriched breast cancer (HER2) and basal-like triple-negative breast cancer (TNBC) [4]
Precision oncology relies on strategies such as genomic profiling to personalise care for breast cancer patients; the 21-gene expression assay (OncotypeDX Recurrence Score©, Genomic Health Inc., Redwood City, CA, USA) is routinely used in ER+/HER2-node-negative early breast cancer patients to select those who will derive the most benefit from systemic chemotherapy prescription, with first results from trial data supporting the expansion of indications to include those with 1–3 positive axillary nodes [6]
Summary
Tumour Heterogeneity and Precision Oncology Breast cancer is the most common cancer in women, with estimations suggesting. The neoadjuvant prescription of systemic therapies allows for the generation of in-vivo data in relation to tumour sensitivity, which has been illustrated to carry prognostic significance for disease recurrence and survival These modern facets of conventional breast cancer management provide insight into the potential utility of novel biomarkers in enhancing the current treatment paradigm. The quantification of miRNAs in liquid biopsy form yields inconsistent results, with apparent uncertainty being cast over what the optimal medium is (i.e., serum, plasma or whole blood) to evaluate miRNA expression levels [22] These physical properties add further complexity to the routine implementation of miRNAs as biomarkers in the clinical setting of breast cancer workup and diagnosis
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