The treatment of breast cancer in the era of precision medicine

Abstract

The management of breast cancer, one of the most common and heterogeneous malignancies, has transformed with the advent of precision medicine. This review explores current developments in genetic profiling, molecular diagnostics, and targeted therapies that have revolutionized breast cancer treatment. Key innovations, such as cyclin-dependent kinases 4/6 (CDK4/6) inhibitors, antibody-drug conjugates (ADCs), and immune checkpoint inhibitors (ICIs), have improved outcomes for hormone receptor-positive (HR+), HER2-positive (HER2+), and triple-negative breast cancer (TNBC) subtypes remarkably. Additionally, emerging treatments, such as PI3K inhibitors, poly (ADP-ribose) polymerase (PARP) inhibitors, and mRNA-based therapies, offer new avenues for targeting specific genetic mutations and improving treatment response, particularly in difficult-to-treat breast cancer subtypes. The integration of liquid biopsy technologies provides a non-invasive approach for real-time monitoring of tumor evolution and treatment response, thus enabling dynamic adjustments to therapy. Molecular imaging and artificial intelligence (AI) are increasingly crucial in enhancing diagnostic precision, personalizing treatment plans, and predicting therapeutic outcomes. As precision medicine continues to evolve, it has the potential to significantly improve survival rates, decrease recurrence, and enhance quality of life for patients with breast cancer. By combining cutting-edge diagnostics, personalized therapies, and emerging treatments, precision medicine can transform breast cancer care by offering more effective, individualized, and less invasive treatment options.

Keywords: Breast cancer; diagnostic precision; personalized therapy; precision medicine.

Figure 1

Key milestones in precision medicine for breast cancer.

Figure 2

Precision medicine for breast cancer. This figure illustrates a personalized treatment framework that integrates diagnostic and therapeutic strategies for patients with breast cancer, regardless of metastasis presence. Tissue and blood samples are analyzed with immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), multi-omics approaches (genomics, proteomics, and transcriptomics), and liquid biopsy techniques (ctDNA/CTCs). Molecular imaging is used to visualize tumor markers, whereas artificial intelligence (AI) aids in data interpretation and decision-making. On the basis of the molecular subtypes, personalized therapies are tailored, including endocrine therapies with or without CDK4/6 inhibitors for HR+/HER2− tumors, HER2-targeted therapies (e.g., trastuzumab) for HER2+ tumors, ChT or immunotherapy for TNBC, and innovative cell/mRNA-based therapies.