Figure 1

Predicting, detecting and monitoring metastatic breast cancer. The figure portrays an omic-signature-based screening strategy for earlier detection of metastasis-prone lesions and high sensitivity detection of residual disease. This strategy is based on the premise that molecular features can be used to define breast cancer subtypes that are at high risk of progressing to metastatic disease. Molecular features associated with metastasis discovered through analysis of metastatic breast cancers are used to develop sensitive assays for disease. This involves a multi-step process in which low-cost blood-based assays of molecular signatures associated with metastasis-prone disease are applied routinely to identify high-risk individuals who are then screened using more expensive but sensitive and specific anatomic assays followed by histopathological and omic assays to identify and characterize even the smallest lesions. The molecular information in individual tumors detected in this way can then be used to develop sensitive blood or imaging based 'individualized' assays for recurrent disease that might be used to guide early detection and treatment. *Image from [80] reprinted with permission from AAAS. All other images were obtained from Wikimedia Commons and are available under public domain, Creative Commons Attribution 3.0 Unported license [92], or Creative Commons Attribution-Share Alike 3.0 Unported license [93].