Overview
Circulating tumor DNA (ctDNA) testing is an emerging tool with the potential to inform risk stratification and clinical decision-making in EBC (stage I-III). However, its real-world use in routine clinical practice and impact have not been well understood.
Using advanced machine learning models, this study identified a cohort of over 195,000 patients with EBC from the Flatiron Health Panoramic database comprised of over 750,000 patients with breast cancer. Researchers found that between 2018 and 2024, ctDNA testing increased more than twofold, with most tests performed after surgery and in patients with stage I or II disease. Importantly, patients with a positive ctDNA test were significantly more likely to experience cancer recurrence and had worse five-year survival rates compared to those with negative tests.
Why this matters
This is the largest real-world study to date examining ctDNA testing in early stage breast cancer. The findings reinforce that a positive ctDNA test is a strong indicator of higher recurrence risk and worse OS across all breast cancer subtypes. These results suggest ctDNA testing could play a key role in guiding follow-up care, patient counseling, and future treatment strategies, ultimately supporting more personalized and effective breast cancer care.