50th JHEP conference 2022
Overview of Non-imaging Technologies That are Expected to be Applied to Breast Cancer Screening
2022 Volume 49 Issue 6 Pages 627-632
Details
2022 Volume 49 Issue 6 Pages 627-632
Breast cancer screening in Japan has been uniformly performed, without considering individualization, with mammography which has scientific evidence of mortality reduction. However, mammography may not be an accurate modality for early detection of breast cancer in patients with dense breast, and ultrasound screening is being explored for younger women.
In the era of genomic medicine, next-generation screening must be individualized and efficient based on the concept of precision medicine. The first is the efficient narrowing down of patients at high risk of developing breast cancer and the selection of the appropriate modality. The integrated analysis of big data from genetic information and electronic medical records may enable subgrouping of residents who are more susceptible to breast cancer, and this method is to continuously perform tests with high diagnostic performance on these groups. The second is the use of body fluids such as blood, tear fluid, and urine. The Aminoindex®, which applies the balance of amino acid concentrations in the plasma of cancer patients compared to healthy individuals to screen for cancer risk, and N-NOSE®, which uses the migration ability of the nematode C. elegans in response to odors emitted from the urine of cancer patients to determine cancer-bearing risk, are already in commercial use. Both are operated as prescreening to evaluate carcinogenic rates and risk of cancer development.
Liquid biopsy, in which microRNAs of exosomes secreted by cancer cells are analyzed using blood or tear fluid, has been reported to have excellent sensitivity and specificity, and a large-scale clinical trial involving 3,000 patients has been initiated.
Cancer screening using body fluids is expected to reduce the burden on both medical professionals and examinees because it is easy to perform, less invasive, and does not involve exposure to X-rays. We believe that verification of the accuracy of cancer screening using these methods should be promoted only for breast cancer, for which existing screening methods are well established.
