The impact of diagnostic tests such as ctDNA on the treatment of breast cancer

Breast cancer (BC) is the most common cancer among women. Due to its global prevalence, many researchers have focused on better understanding the biology of cancer and developing innovative tools for the diagnosis and treatment of BC. Liquid biopsy is a non-invasive technique that can provide important diagnostic, therapeutic, and prognostic information for various cancers. One component of liquid biopsy is known as circulating tumor DNA (ctDNA), which is released by tumors during apoptosis and necrosis and constitutes part of cfDNA in blood plasma. ctDNA has emerged as an attractive non-invasive method for identifying cancer-specific genetic alterations in blood plasma, including DNA mutations and methylation patterns. It also aids in tumor burden monitoring, assessing treatment response, identifying significant changes, diagnosing residual disease, and screening for early tumors in asymptomatic patients. Analyzing circulating tumor components, especially ctDNA, provides molecular footprints from the entire tumor, enabling real-time monitoring of tumor evolution. Methods: We collected relevant articles from November ۱, ۲۰۱۹, to June ۱۹, ۲۰۲۴, from databases such as Google Scholar and PubMed. A total of nine articles were included in this systematic review. Results: With recent advances in molecular technology, the analysis and identification of bodily fluids have been the subject of numerous studies, demonstrating that liquid biopsy can assist in decision-making and personalized treatment for breast tumors. The main prospects of using liquid biopsy include early detection, metastasis identification, real-time monitoring, and treatment selection for drug resistance. Recent studies have shown that cancer patients have higher levels of circulating DNA compared to healthy individuals, and this free DNA can be used for various purposes. The source of ctDNA is cellular degradation from tumors through apoptosis, necrosis, or phagocytosis, although it may also derive from actively secreted cellular components. Utilizing ctDNA as a clinical biomarker has the potential to identify preclinical disease recurrence in patients after breast cancer treatment. In the era of personalized medicine, ctDNA has emerged as a promising tool for guiding future precise medical practices. Conclusion: There remains a need for new technologies that help physicians better treat patients with breast cancer. Liquid biopsies, particularly ctDNA, can bring healthcare providers closer to this goal. Liquid biopsies offer various advantages over tissue biopsies; while tissue biopsies provide information about the tumor at a specific time and place, liquid biopsies have the potential to non-invasively assess the spatial and temporal diversity of tumors. The use of liquid biopsy and ctDNA analysis in breast cancer provides opportunities to encompass all possible disease states. However, many challenges remain to be addressed. Nonetheless, the incorporation of liquid biopsy into current research projects and clinical trials is promising and seems to be a precursor for its implementation in clinical practice in the near future. Furthermore, significant advancements in recent years continue to explore the emerging role of ctDNA in breast cancer management, with potential for further expansion through prospective studies.

کلیدواژه ها:

ctDNA ، breast cancer ، liquid biopsy