Disease Diagnosis | Strategy for breast cancer from screening to treatment

Part 1: Global Burden

Breast cancer is one of the most common malignant tumors and has the highest incidence rate among women. According to the latest data from the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) for 2022, there were 9.66 million new cancer cases among women globally, with breast cancer rapidly rising to 2.29 million cases, making it the most prevalent cancer among women, accounting for 23.8% of all female malignant tumors [1].

Part 2: Strategies for Breast Cancer Management

The incidence of breast cancer increases with age, starting from 1.5 cases per 100,000 women aged 20-24 and peaking at 421.3 cases per 100,000 women aged 75-79. Notably, 95% of new cases occur in women aged 40 and older, with a median diagnosis age of 61 [2]. Furthermore, early-stage breast cancer often presents no typical symptoms, leading to most diagnoses occurring at advanced stages. Early detection is critical; the sooner breast cancer is identified, the better the treatment outcomes. Implementing the principle of "early detection, early diagnosis, and early treatment" can significantly reduce both the incidence and mortality rates of breast cancer.

1) High-risk populations

According to the Breast Cancer Treatment Guidelines (2022 Edition), high-risk groups of breast cancer who should undergo early detection (under 40 years old) include [3]:

○ Individuals with a significant genetic predisposition to breast cancer.

○ Those with a history of atypical hyperplasia or lobular carcinoma in situ.

○ Patients who have previously received chest radiation therapy.

2) Screening method

The rate of early diagnosis for breast cancer remains low due to limitations in routine examination methods, such as mammography and pathological testing, which may cause interventional trauma and discomfort leading to poor patient compliance. Combining tumor marker tests can enhance detection sensitivity, reducing the likelihood of missed or misdiagnosed cases, and holds significant clinical importance for early detection, treatment efficacy monitoring, recurrence tracking, and overall prognosis.

3) Whole-process monitoring

-Combined detection of tumor markers can enhance diagnostic accuracy for breast cancer.

A meta-analysis of 21 studies indicated that the combined detection of serum CEA, CA125, and CA153 achieved a comprehensive ROC curve area of 0.94 (95% CI: 0.91-0.95) [4].

-Combined detection of tumor markers can significantly improve sensitivity in identifying recurrence and metastasis of breast cancer

Breast Cancer Treatment Guidelines (2022 Edition) highlight that the combined detection of CA153 and CEA significantly enhances the sensitivity for identifying the recurrence and metastasis of breast cancer, which is also crucial for effectively monitoring the progression of metastatic breast cancer [3].

-Regular monitoring of serum HER-2 levels helps to evaluate the efficacy of HER-2 targeted therapies

The National Comprehensive Cancer Network (NCCN) Guidelines for metastatic breast cancer (2020)?recommend that HER-2-positive patients with recurrent and metastatic breast cancer undergo regular serum HER-2 testing[5]. This practice allows for real-time assessment of treatment efficacy.

As a non-invasive and automated indicator, breast cancer tumor markers play a significant role in early diagnosis, treatment efficacy monitoring, recurrence tracking, and overall prognosis.

Part 3: Snibe Total Diagnostic Solution for Breast Cancer

Snibe has developed a comprehensive solution for breast cancer management, which includes but is not limited to the test menu of CA 153, CA 125, CEA, and HER-2, and better meets the needs of different medical institutions for early breast cancer screening.

Reference:

[1] Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024; 74(3): 229-263.

[2] Menon G, Alkabban FM, Ferguson T. Breast Cancer. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2024.

[3] Breast Cancer Treatment Guidelines (2022 Edition). Medical Policy and Administration Agency, National Health Commission of the People's Republic of China. Chinese Journal of Oncology. 2023; 45(10), 803-833.

[4] Ma X, Wang N, Yin J, Wang Q. Meta-analysis of the value of serum CEA, CA153, and CA125 tests in opportunistic screening for breast cancer in Chinese population. Chinese Journal of Health Management. 2024; 18(04): 263-270.

[5] NCCN Guidelines for Patient: Metastatic Breast Cancer. Journal of the National Comprehensive Cancer Network. 2024.