Triple Negative Breast Cancer: A Review of Present and Future Diagnostic Modalities

Abstract

Triple-negative breast cancer (TNBC) is an aggressive breast type of cancer with no expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). It is a highly metastasized, heterogeneous disease that accounts for 10-15% of total breast cancer cases with a poor prognosis and high relapse rate within five years after treatment compared to non-TNBC cases. The diagnostic and subtyping of TNBC tumors are essential to determine the treatment alternatives and establish personalized, targeted medications for every TNBC individual. Currently, TNBC is diagnosed via a two-step procedure of imaging and immunohistochemistry (IHC), which are operator-dependent and potentially time-consuming. Therefore, there is a crucial need for the development of rapid and advanced technologies to enhance the diagnostic efficiency of TNBC. This review discusses the overview of breast cancer with emphasis on TNBC subtypes and the current diagnostic approaches of TNBC along with its challenges. Most importantly, we have presented several promising strategies that can be utilized as future TNBC diagnostic modalities and simultaneously enhance the efficacy of TNBC diagnostic.

Keywords: breast cancer; future diagnosis; triple negative breast cancer.

Figure 1

The intrinsic subtyping of breast cancer based on immunohistochemical profile.

Figure 2

The subtypes of triple negative breast cancer.

Figure 3

Working principles of nanobiosensor. Bioreceptor form biological reaction when bind to sample analyte which caused changes in either current, wavelength, mass, or temperature. The biological response will then be converted to electrical signals via the transducer. Nanomaterials that integrate with transducers is to detect low concentrations of analytes.

Figure 4

Overview of dPCR. Sample is added and combined with qPCR reagent. It is then equally distributed into many sub-volumes (either in microwells, chambers, or droplets) which results in some partitions to contain few targets and some without. Each subdivided portion will undergo amplification. The positive columns will be identified and the target concentrations will be determined via Poisson’s statistics.