Biomarkers for Risk Assessment and Prevention of Breast Cancer
Pp. 212-273 (62)
Massimiliano Cazzaniga, Andrea Decensi, Bernardo Bonanni, Alberto Luini and Oreste Gentilini
Breast carcinogenesis is a multistep and multipath disease process which
occurs in the epithelium lining of the ductal system in the vast majority of cases.
Several studies have shown that the relative risk of breast cancer increases in every step
of this progression and many tumour associated antigens or biomarkers appear during
each phase of carcinogenesis. However, their ability to predict for a substantial
likelihood of developing breast cancer remains unclear. The acquisition of breast tissue
samples, representative of an individual’s cellular stability and subcellular biochemical
and molecular state could lead to definition of surrogates for risk, early detection,
pharmacodynamic determination and finally chemopreventive intervention. The
intraductal approach includes nipple aspiration fluid (NAF), ductal lavage (DL) and
mammary ductoscopy (MD). These techniques together with random periareolar fine
needle aspiration (RPFNA) represent the available techniques for the sampling of breast
fluid and exfoliated epithelial cells. At the moment, these procedures are not considered
a screening procedure for early breast cancer detection but might provide a powerful
research tool for studying breast carcinogenesis in vivo.
We summarize the current knowledge regarding the vast array of molecules involved at
all stages of carcinogenesis and the possibility to utilize them as candidate biomarkers
to refine risk assessment, and their possible use in prevention strategies.
Biomarkers, prevention and breast cancer, risk assessment.
Division of Cancer Prevention and Genetics, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.