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World J Clin Oncol. Apr 10, 2018; 9(2): 26-32
Published online Apr 10, 2018. doi: 10.5306/wjco.v9.i2.26
Cell-free DNA integrity for the monitoring of breast cancer: Future perspectives?
Navid Sobhani, Daniele Generali, Fabrizio Zanconati, Marina Bortul, Bruna Scaggiante
Navid Sobhani, Daniele Generali, Fabrizio Zanconati, Marina Bortul, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Academic Hospital, Trieste 34149, Italy
Bruna Scaggiante, Department of Life Sciences, University of Trieste, Trieste 34127, Italy
Author contributions: Scaggiante B developed the original idea, researched the literature and edited the manuscript; Sobhani N contributed to the development of the idea, researched the literature and edited the manuscript’s content and language; Generali D contributed to developing the oncological aspects and edited the manuscript; Zanconati F contributed to developing the idea as a pathologist; Bortul M contributed to the editing the manuscript as a breast cancer surgeon.
Conflict-of-interest statement: No conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bruna Scaggiante, PhD, Professor, Department of Life Sciences, University of Trieste, Giorgeri 1, Trieste 34127, Italy. bscaggiante@units.it
Telephone: +39-40-5583686
Received: November 25, 2017
Peer-review started: November 25, 2017
First decision: January 15, 2018
Revised: February 2, 2018
Accepted: March 14, 2018
Article in press: March 14, 2018
Published online: April 10, 2018
Processing time: 136 Days and 16.6 Hours
Abstract

Breast cancer (BC) is the most common cancer and the second cause of death in women worldwide. Therapeutic options are increasing, but the response to treatments is not always efficient and the risk of recurrence covers decades. In this perspective, the need to have a proper follow-up for the therapeutic responses and for anticipating recurrence it is urgent in the clinical setting. Liquid biopsy provides the basic principle for a non-invasive method for the routinely monitoring of BC. However, due to the heterogeneity of tumors during onset and progression, the search for tumor DNA mutations of targeted genes in plasma/serum is a limiting factor. A possible approach overtaking this problem comes from the measurement of cell-free DNA integrity, which is an independent factor from the mutational status and theoretically is representative of all tumors. This review summarizes the state-of-the-art of cell-free DNA integrity researches in BC, the controversies and the future perspective.

Keywords: cfDNA integrity; Liquid biopsy; Breast cancer; ALU sequences; LINE-1 sequences

Core tip: Despite the potentiality of cell-free DNA integrity as a useful tool for the monitoring of Breast Cancer (BC), evinced in some clinical studies, the scientific community has not reached agreeable conclusions to translate the results from the bench-to-the-bedside yet. The main controversy regards the targets’ choice and the size of circulating cell-free tumor DNA fragments. This work underlines the utility of cell-free DNA Integrity evaluation for BC follow-up and at the same time highlights the common concepts explaining the different results in line of future directions.