Genome-wide cell-free DNA methylation analyses improve accuracy of non-invasive diagnostic imaging for early-stage breast cancer

Mol Cancer. 2021 Feb 19;20(1):36. doi: 10.1186/s12943-021-01330-w.

Abstract

Early detection is crucial to improve breast cancer (BC) patients' outcomes and survival. Mammogram and ultrasound adopting the Breast Imaging Reporting and Data System (BI-RADS) categorization are widely used for BC early detection, while suffering high false-positive rate leading to unnecessary biopsy, especially in BI-RADS category-4 patients. Plasma cell-free DNA (cfDNA) carrying on DNA methylation information has emerged as a non-invasive approach for cancer detection. Here we present a prospective multi-center study with whole-genome bisulfite sequencing data to address the clinical utility of cfDNA methylation markers from 203 female patients with breast lesions suspected for malignancy. The cfDNA is enriched with hypo-methylated genomic regions. A practical computational framework was devised to excavate optimal cfDNA-rich DNA methylation markers, which significantly improved the early diagnosis of BI-RADS category-4 patients (AUC from 0.78-0.79 to 0.93-0.94). As a proof-of-concept study, we performed the first blood-based whole-genome DNA methylation study for detecting early-stage breast cancer from benign tumors at single-base resolution, which suggests that combining the liquid biopsy with the traditional diagnostic imaging can improve the current clinical practice, by reducing the false-positive rate and avoiding unnecessary harms.

Publication types

  • Letter
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / genetics
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / genetics*
  • Cell-Free Nucleic Acids / genetics*
  • DNA Methylation*
  • Early Detection of Cancer
  • Epigenesis, Genetic
  • Female
  • Humans
  • Liquid Biopsy
  • Mammography
  • Proof of Concept Study
  • Prospective Studies
  • Ultrasonography, Mammary
  • Whole Genome Sequencing / methods*

Substances

  • Biomarkers, Tumor
  • Cell-Free Nucleic Acids

Associated data

  • ChiCTR/ChiCTR1900026080