Tumor-educated platelets: A new field in breast cancer diagnosis

Tumor-educated platelets (TEPs) represent a novel approach in liquid biopsy, offering new perspectives for diagnosing, treating, and monitoring breast cancer. Unlike traditional histopathological biopsies-the current diagnostic gold standard-TEP-based detection is minimally invasive, requiring only peripheral blood samples and overcoming limitations of repeated invasive procedures. TEPs reflect a dynamic interplay between tumor cells, platelets, and the tumor microenvironment: tumors alter platelet expression profiles while TEPs provide comprehensive molecular information about tumor genetics. This bidirectional relationship positions TEPs as highly promising biomarkers for early detection and non-invasive monitoring. Since early-stage breast cancer patients often achieve complete remission through surgery and standardized therapy, developing promising sensitivity and specific early diagnostic markers is crucial. Recently, liquid biopsy has gained significant momentum in breast cancer research, with TEPs emerging as particularly promising tools for cancer surveillance, treatment guidance, and diagnosis. This review examines TEP reprogramming mechanisms, current research advances, and the latest developments in TEP-based breast cancer applications (Graphical abstract).