Blood-Based Cancer Biomarkers as a Complement to Mammography : Benefits and Trade-Offs

Sammanfattning

Mammography is currently the standard method for breast cancer screening, yet up to 20% of cases remain undetected. This study investigates the potential of blood-based biomarker tests as a complementary tool to improve diagnostic accuracy in routine mammography screening programs. A literature review was conducted to identify key biomarker tests. Tests selected for inclusion were CancerSEEK, CA 15-3, ctDNA, CEA + CA 15-3, cCOL IV, and two miRNA models. Data on sensitivity and specificity were collected for each test, and Monte Carlo simulations were employed to estimate key diagnostic metrics such as false positive rate, false negative rate, positive predictive value, and the increase in detected cases, both for individual biomarker tests and in combination with mammography. The results demonstrated that miRNA model 1, miRNA model 2, and ctDNA showed the strongest overall performance in terms of sensitivity and PPV. When combined with mammography, these tests notably increased the number of detected breast cancer cases, though often at the cost of higher false positive rates. The study concludes that blood-based biomarker tests can serve as a valuable complement to mammography, enhancing early detection and potentially improving patient outcomes in clinical breast cancer screening.