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Evaluation of nipple aspirate fluid as a diagnostic tool for early detection of breast cancer
Shaheed, Sadr-ul Tait, C. Kyriacou, K. Linforth, R. Salhab, M. Sutton, Chris W.
Shaheed, Sadr-ul
Tait, C.
Kyriacou, K.
Linforth, R.
Salhab, M.
Sutton, Chris W.
Publication Date
2018-01-11
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© The Author(s) 2018. This article is distributed under the terms of the
Creative Commons Attribution 4.0 International License
(http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and
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The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/
publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise
stated.
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openAccess
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2017-12-22
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Abstract
There has been tremendous progress in detection of breast cancer in postmenopausal women, resulting in two-thirds
of women surviving more than 20 years after treatment. However, breast cancer remains the leading cause of cancerrelated
deaths in premenopausal women. Breast cancer is increasing in younger women due to changes in life-style
as well as those at high risk as carriers of mutations in high-penetrance genes. Premenopausal women with breast
cancer are more likely to be diagnosed with aggressive tumours and therefore have a lower survival rate. Mammography
plays an important role in detecting breast cancer in postmenopausal women, but is considerably less sensitive
in younger women. Imaging techniques, such as contrast-enhanced MRI improve sensitivity, but as with all imaging
approaches, cannot differentiate between benign and malignant growths. Hence, current well-established detection
methods are falling short of providing adequate safety, convenience, sensitivity and specificity for premenopausal
women on a global level, necessitating the exploration of new methods. In order to detect and prevent the disease
in high risk women as early as possible, methods that require more frequent monitoring need to be developed. The
emergence of “omics” strategies over the last 20 years, enabling the characterisation and understanding of breast cancer
at the molecular level, are providing the potential for long term, longitudinal monitoring of the disease. Tissue and
serum biomarkers for breast cancer stratification, diagnosis and predictive outcome have emerged, but have not successfully
translated into clinical screening for early detection of the disease. The use of breast-specific liquid biopsies,
such as nipple aspirate fluid (NAF), a natural secretion produced by breast epithelial cells, can be collected non-invasively
for biomarker profiling. As we move towards an age of active surveillance, home-based liquid biopsy collection
kits are increasingly being applied and these could provide a paradigm shift where NAF biomarker profiling is used for
routine breast health monitoring. The current status of established and newly emerging imaging techniques for early
detection of breast cancer and the potential for alternative biomarker screening of liquid biopsies, particularly those
applied to high-risk, premenopausal women, will be reviewed.
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Citation
Shaheed S, Tait C, Kyriacou K et al (2018) Evaluation of nipple aspirate fluid as a
diagnostic tool for early detection of breast cancer. Clinical Proteomics. 15(3).
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Article