Abstract
OBJECTIVES: To investigate the clinical diagnostic and prognostic value of extrachromosomal circular DNA (eccDNA) in breast cancer, eccDNA profiles were constructed for 81 breast cancer tumor tissues and 33 adjacent non-tumor tissues. METHODS: The distribution characteristics of eccDNA across functional genomic elements and repetitive sequences were systematically analyzed. Furthermore, a diagnostic model for differentiating malignant and normal breast tissues, as well as a prognostic prediction model, was developed using a random forest algorithm. RESULTS: EccDNA in breast cancer tissues harbor a higher proportion of functional elements and repetitive sequences, with their annotated genes significantly enriched in tumor- and immune-related pathways. However, no significant differences in eccDNA features were observed across breast cancer subtypes or pathological stages. In the validation cohort, the eccDNA-based diagnostic model achieved an AUC of 0.83, with repetitive elements and enhancer-associated features contributing the most to diagnostic performance. The prognostic model achieved an AUC of 0.78, with repetitive element annotations also showing strong prognostic relevance. CONCLUSIONS: These findings highlight the promising potential of eccDNA in the development of precision diagnostics and prognostic systems for breast cancer.