Breast Cancer Imaging: Clinical Translation of Novel Methods

Breast cancer has become the most common cancer in women, and the incidence rate has increased by 6% in the past decade with a projected increase of 2% between 2014 and 2035. In the EU, women over 45 receive regular radiological screening, while younger women at high-risk of developing breast cancer receiving annual surveillance. However, current radiological approaches are suboptimal suffering from high false positive and negative rate, leading to overtreatment and late detection. Locally advanced breast cancer (LABC) is diagnosed in approximately 4% of the patients in the EU to 30-60% in developing countries, and neoadjuvant chemotherapy (NACT) is increasingly used to improve surgical outcome. However, 10-20% of the patients do not respond to the treatment leading to unnecessary exposure to drug toxicity and delay in surgery, demanding imaging markers sensitive to tumour metabolism rather than crude tumour size estimation in current radiological methods.

There is an urgent unmet clinical need for novel radiological methods to facilitate accurate early detection and treatment monitoring in breast cancer. Current radiological methods for breast cancer diagnosis and treatment monitoring are primarily mammography, ultrasound and magnetic resonance (MR) imaging. Mammography is primarily sensitive to the presence of microcalcification in the tumour, while ultrasound is sensitive to solid mass in the tumour against fluid-filled lesion. MR imaging is based on dynamic contrast enhanced (DCE) method, and is sensitive to the presence of abnormal vasculature in tumour. However, there have been major advances in medical imaging in recent years, ranging from novel ultrasound apparatus, functional MR imaging and spectroscopy, targeted PET tracers for nuclear medicine, to multi parametric and modal approaches. These innovations not only potentially enhance the accuracy of diagnosis, but also may offer critical information previously unavailable from radiological examination for treatment planning leading to an alteration of healthcare pathway. We therefore would like to highlight the recent development of breast imaging methods in this Research Topic, to facilitate the clinical translation.

This Research Topic will focus on early phase and proof of concept clinical trials for the clinical translation of novel imaging methods for the early diagnosis and treatment response monitoring of breast cancer. The manuscript should clearly articulate the healthcare pathway the imaging method seeks to improve or alter, and the study should be conducted in a straightforward procedure with uncomplicated implementation in the clinic. The studies should be hypothesis driven in a prospective manner with the potential clinical translation of the imaging methods as the primary novelty, although supporting retrospective bioinformatics analysis could be included. Reference to regulatory approval and clinical trial registration in public database, if available, should be included, and compliance to Medical Device Directive, if related to imaging hardware innovation, should also be included. Although small cohort size is common in early phase trials, the cohort size should allow adequate evidence to justify further in-depth investigation.

Please note, manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.