Detecting stage 1 breast cancer remains a challenge for clinicians, as small tumors often evade traditional imaging methods. Moreover, approximately 80% of detected breast masses are benign, leading to a high rate of unnecessary needle biopsies, procedures that bring both emotional and financial burdens to patients.
A recent study has taken a significant step toward addressing these issues by identifying enolase 1 as a potential liquid biopsy biomarker for early breast cancer detection. Researchers analyzed extracellular vesicles isolated from plasma samples of healthy individuals, patients with benign breast disease, and those with stage 1 breast cancer. Using mass spectrometry, they found 94 proteins significantly altered in the cancer cohort. Among these, enolase 1 stood out as a consistent and robust candidate.
Subsequent high-throughput ELISA assays confirmed that plasma enolase 1 levels were significantly higher in patients with stage 1 breast cancer compared to healthy or benign cases. Importantly, enolase 1 levels dropped after tumor removal, strengthening its candidacy as a dynamic disease marker.
The team’s findings suggest that enolase 1 could serve as a minimally invasive blood-based diagnostic tool, particularly valuable in combination with existing imaging techniques. Such a test could help distinguish between benign and malignant growths, potentially reducing the large number of unnecessary biopsies currently performed.
However, the authors note that while the diagnostic accuracy (AUC ~0.78) is promising, enolase 1 alone may not achieve sufficient specificity for clinical use. Because it is expressed in multiple tissue types and implicated in other cancers, a multi-biomarker panel approach may enhance both sensitivity and specificity. The study’s proteomic data provide a foundation for identifying additional candidates to complement enolase 1.