Pathways to personalized medicine for breast and prostate cancers: emerging diagnostic methods and prognostic biomarkers.

Early and personal diagnosis to breast a prostate cancer is crucial for optimizing treatments leading to long-term patient survival. Once cancer metastasizes from the breast or prostate to other tissues of the body, therapies are limited, and there is no cure for the diseases. Currently used screening modalities for breast and prostate cancers have limitations. Routine screening for breast cancer includes clinical breast exams and mammograms. Improvements in imaging techniques, such as magnetic resonance, ultrasound, digital breast tomosynthesis and ductography are being explored as adjuncts to mammography. A new approach to breast cancer screening involves the detection of abnormalities at the cellular level and uses various means to collect cellular material from the ductal system, including nipple aspirate fluid, breast ductal lavage, fiberoptic ductoscopy and random periareolar fine needle aspiration. Current screening methods for prostate cancer include digital rectal exam and serum PSA levels. However, these methods offer low sensitivity and specificity and do not allow differentiation between significant- and minimal-risk cancers. New approaches to prostate cancer screening involve different calculations using PSA, as well as molecular urine tests. With the recent advances in microarray technologies and whole-genome sequencing of tumors, the identification of specific biomarkers for diagnosis and prognosis, as well as new therapeutic targets, is quickly paving the way for personalized medicine. In the future, routine patient care will include using the molecular signature of a patient's disease to guide treatment.