Current and potential diagnostic modalities in the detection and management of breast cancer

Global statistics have demonstrated that breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among female patients, accounting for 23 percent of total cancer cases and 14 percent of cancer deaths. Survival following a diagnosis of breast cancer is grossly determined by the stage of the disease at the time of initial diagnosis, highlighting the gravity of early detection. Improving early diagnosis will require a multi-faceted approach, including optimising the use of current available imaging modalities, in addition to investigating new methods of detection from a biochemical and radiological perspective. To further improve our knowledge on the use of current modalities, this thesis investigated the use of preoperative breast MRI in patients with invasive lobular breast cancer. While MRI was associated with minor delays in treatment and did not reduce overall rates of margin re-excision or completion mastectomy, it altered the choice of surgical procedure in almost a quarter of cases where MRI was utilised. Next, the potential role of microwave breast imaging was explored, and a First-in-Human trial conducted where the Wavelia system was introduced into the clinical setting. This novel system demonstrated exciting potential in the detection, localisation and characterisation of breast lesions. This modality may have the potential to offer a non-invasive, non-ionizing and painless adjunct to breast cancer diagnosis. Further larger studies are planned to validate the findings of this study. Finally, the potential of a circulating biomarker of breast cancer was investigated. Extracellular vesicles (EVs) are secreted by cells and shuttle bioactive materials including microRNAs (miRNA) throughout the circulation and are believed to represent a fingerprint of the cell of origin. As a result, recent years have seen an immense interest in their potential as a biomarker of breast cancer. In this work, EVs derived from breast-tumour bearing animals, breast cancer patients and healthy ...