AbstractThe 5-year breast cancer survival rate in the United States is 91% overall with a 99% survival rate for localized disease. Early detection via mammograms has largely been responsible for the success of finding breast cancer early; however, mammograms have drastically decreased effectiveness in women with dense breasts tissue which is approximately half of the US population. To better serve these women, an alternative screening method is necessary. Astrin Biosciences has developed a multi-modal liquid biopsy-based alternative for breast cancer screening in this population.Recent literature demonstrates that cancer cells disseminate into blood vessels even at early stages. These early-stage cells are a potential source of late recurrence and therapy resistance but have strong potential benefit in early detection as well as provide opportunities to determine possibly curative interventions. Although these cell assays have a huge potential benefit, they generally leave some to be desired as far as sensitivity due to the rarity of these cells with less than 10 cells per 10 mL blood tube from circulation. To overcome this limitation, Astin’s algorithm pairs our AI-empowered proprietary holographic imaging platform with plasma proteomics. This pairing provides increased sensitivity over a cell-based assay alone while maintaining the ability to detect disseminating cells for further analysis in patients with enough cells present.This combined technology was evaluated in a cohort of more than 100 newly diagnosed early-stage breast cancer patients (Stage 0, 1, and 2). Blood samples were collected prior to initiation of therapy and the plasma and cell fractions were separated. Proteomic analysis was performed on the plasma sample while Astrin’s holographic imaging platform combined with in-flow protein marker expression was used to analyze the samples for circulating tumor cells. Preliminary data from this study demonstrates evidence of early dissemination detectable in the majority of breast cancer patients. GSEA analysis of protein expression revealed well known pathways associated with cancer biology. Astrin Biosciences’ combined assay has the ability to detect cancer in women with dense breast, increasing the likelihood cancer is detected early in this population.Citation Format:Kaylee J. Kamalanathan, Alec Horrmann, Nathaniel R. Bristow, Yash Travadi, Kevin Mallery, Catalina Galeano-Garces, Song Yi Bae, Alexa Hesch, Grant Schaap, Yuliya Olimpiadi, Sarah Pederson, Jiarong Hong, Justin Drake, Jayant Parthasarathy, Badrinath R. Konety. Multi-modal liquid biopsy analysis of early-stage breast cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1026.