Crossroads: The role of biomarkers in the management of lumps in the breast

A new research perspective was published in Oncotarget's, titled "Crossroads: the role of biomarkers in the management of lumps in the breast."

Here, Dr. Georg F. Weber from the University of Cincinnati Academic Health Center discusses a long-standing issue in women's health: lumps in the breast. Women over the age of 40 years often have lumps in their breasts that are not cancerous at the time of biopsy (comprising atypias, hyperplasias, papillomas, radial scars, lobular carcinoma in situ, ductal carcinoma in situ (DCIS)). These premalignant lesions in the breast pose a difficult decision-making problem, whether to treat proactively and accept the side effects or to engage in watchful waiting and possibly encounter a later diagnosis of invasive cancer.

These patients need to make the difficult decision whether to treat the lesions proactively and accept the substantial compromise in their quality of life (from surgery, radiation, or hormone therapy: Surgery often ensues for definitive diagnosis. Radiation may follow the surgical resection of DCIS by lumpectomy. Hormone therapy can come into play as a strategy for risk reduction if the estimated 5-year risk exceeds 1.6% in the Gail model) or to engage in watchful waiting and risk a later diagnosis of invasive cancer (the proverbial sword of Damocles). Currently, two forms of assessment are available to facilitate making that choice.

Decades of cancer diagnosis and treatment have achieved substantial improvements. Yet, with every milestone of progress, new needs have surfaced. Breast care is privileged to have the availability of mammography and biopsy to assess the propensities of lumps.

"A meaningful next step needs to entail biomarker development, pointing the way toward either preemptive treatment or watchful waiting at the crossroad," says Weber