Breast cancer is one of the most common types of cancers that affect women, and while the disease is not preventable due to its nuanced and often complex origins, technology has improved in the past decades that have allowed for better – and earlier – intervention. With careful monitoring and treatment, we have the potential to improve disease prognosis and patient outcomes.

Current monitoring methods for breast cancer involve a combination of biomarker testing, imaging scans, and clinical assessments.  These methods are employed to evaluate treatment response, detect disease recurrence, and optimize treatment planning. 

The most common monitoring methods thus far include biomarker testing, imaging scans, clinical assessments, and biopsies. These methods are typically done together, incorporated into a comprehensive approach that considers the patient’s individual characteristics, stage of cancer, treatment plan, and response to therapy.

In this article, we will look at the current approaches in breast cancer monitoring, examining each one and the role they play in helping healthcare providers optimize disease monitoring and treatment strategy.

Biomarker testing

Biomarker testing involves the analysis of specific molecules of genetic markers associated with the disease to monitor its development and progression. Breast cancer biomarkers that are frequently used to monitor tumor growth and response treatment include CA15-3, CA27.29, Ki-67, and TKa (Thymidine Kinase activity).

CA stands for Cancer Antigen, and CA15-3 and CA27.79 are tumor markers measured in the blood of breast cancer patients. They are both forms of a protein called MUC1, found on the surface of cancer cells. When clinicians monitor the levels of these cancer antigens over time, they can find information on the presence of the disease.

Ki-67 is a protein marker used to assess the proliferation rate of cancer cells. It is measured through IHC (immunohistochemistry), and Ki-67 can be analyzed through staining tissue samples that are obtained from biopsies. This leads healthcare providers to learn more about how aggressive a tumor is and guide treatment decisions.

Thymidine Kinase is an enzyme involved in the proliferation of cells, as TK1 plays a key role in DNA synthesis. TK activity levels can be measured in the blood and elevated TKa levels are associated with more aggressive disease. This can help doctors determine if a treatment plan is working and how best to optimize the journey.

Imaging scans

Imaging scans are typically used by doctors to detect breast abnormalities and to monitor tumor development or calcifications during disease progression. Some examples of imaging methods include mammography, ultrasound, MRI, and PET scans. They all provide doctors with avenues for better and more accurate monitoring of disease progression.

Mammograms are X-rays which are used to monitor tumor development during the treatment journey, which can be useful to help healthcare providers determine the efficacy of therapies and medication. Breast ultrasounds involve the use of sound waves to create images of the breast tissue, which can create clarity around suspicious areas. In some cases, it can also help doctors decide if a needle biopsy is needed.

MRI stands for Magnetic Resonance Imaging, and breast MRI uses powerful magnetic and radio waves to create detailed images of the breast. This is a useful method for doctors to determine the extent of the cancer and to assess the patient’s response to neoadjuvant therapy.

Finally, PET stands for Positron Emission Tomography, and PET scans involve injecting radioactive tracers into the patient. These tracers are taken up by active cancer cells, allowing doctors to assess the spread of cancer to other parts of the body. This is particularly important in patients with advanced (metastatic) breast cancer.

Clinical assessments

Alongside imaging scans, clinical assessments like physical exams and blood tests can provide insights into disease management. Doctors assess physical changes in the breast tissues and lymph nodes of patients, and routine blood tests can provide information on the overall health of the patient undergoing treatment. This is important, because treatment for cancer is typically strong and can produce a host of unwanted side effects on other organs. Biomarkers can also be obtained and analyzed through blood samples.

Biopsies

Finally, a biopsy involves the removal of a small tissue sample for examination under a microscope. Biopsies are relatively invasive, as they are performed using various techniques, such as core needles, or through fine-needle aspiration or surgery. Biopsies, however, provide accurate information at the early stages of cancer, as it can confirm disease presence and determine tumor characteristics.

Final words 

Breast cancer management has improved over the years due to technological advances that enable extensive scientific discoveries. These four monitoring methods mentioned are typically incorporated into a comprehensive approach that considers the individual patient’s characteristics, stage of cancer, treatment plan, and response to therapy. The specific monitoring strategies may vary based on the patient’s unique circumstances and the recommendations of the healthcare team, but with a combined approach, doctors are now able to gain more accurate insights into patient journeys than ever.

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