Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series
Despite initial treatment, breast cancer recurrence affects approximately 30% of patients. Currently, there exists no standardized approach to detect recurrence before clinical or radiologic signs manifest. Circulating tumor DNA (ctDNA) is a minimally invasive blood test that offers potential to mon...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-07-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359251351121 |
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| author | Kasen Wong Alyssa Kameoka Jami Aya Fukui |
| author_facet | Kasen Wong Alyssa Kameoka Jami Aya Fukui |
| author_sort | Kasen Wong |
| collection | DOAJ |
| description | Despite initial treatment, breast cancer recurrence affects approximately 30% of patients. Currently, there exists no standardized approach to detect recurrence before clinical or radiologic signs manifest. Circulating tumor DNA (ctDNA) is a minimally invasive blood test that offers potential to monitor molecular disease and individualize care. This study explores the utility of ctDNA in recurrence monitoring and clinical decision-making for high-risk breast cancer cases within a community setting. Seventy-two patients with high-risk breast cancer features—defined as stage III disease, triple-negative or HR−/HER2+ following neoadjuvant treatment, metastatic breast cancer without evidence of disease, bilateral breast cancer history, high-risk genetics (BRCA1/BRCA2 mutations), <40 years old at diagnosis, or history of breast cancer recurrence—were offered tumor-informed ctDNA assays at 3- to 6-month intervals. Analysis was conducted on 67 cases with a mean diagnostic age of 52.69 at diagnosis. The cohort was ethnically diverse, including White ( n = 21, 31.82%), Japanese ( n = 15, 22.73%), Native Hawaiian ( n = 11, 16.67%), and Filipino ( n = 7, 10.61%) patients. Seven (10.45%) tests were positive: six predicted recurrence despite four with initially negative radiological findings, and one prompted treatment resumption following prior non-adherence. However, one negative result was false and later showed a contralateral breast recurrence, and another negative test coincided with a new primary cholangiocarcinoma. In two cases, ctDNA negativity was utilized to monitor treatment response in metastatic disease and inform therapeutic adjustments. In real-world settings, ctDNA served as a valuable tool for earlier recurrence prediction, expediting radiological confirmation, and influencing treatment. Nevertheless, false results carry the risk of hindering effective care and inducing considerable patient anxiety. Future large-scale studies are warranted in high-risk breast cancer populations to evaluate ctDNA’s impact on patient survival outcomes, treatment monitoring, and patients’ emotional experiences. |
| format | Article |
| id | doaj-art-d169067fdab54fbb9802b9d1a870028f |
| institution | Kabale University |
| issn | 1758-8359 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj-art-d169067fdab54fbb9802b9d1a870028f2025-08-20T03:33:18ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-07-011710.1177/17588359251351121Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case seriesKasen WongAlyssa KameokaJami Aya FukuiDespite initial treatment, breast cancer recurrence affects approximately 30% of patients. Currently, there exists no standardized approach to detect recurrence before clinical or radiologic signs manifest. Circulating tumor DNA (ctDNA) is a minimally invasive blood test that offers potential to monitor molecular disease and individualize care. This study explores the utility of ctDNA in recurrence monitoring and clinical decision-making for high-risk breast cancer cases within a community setting. Seventy-two patients with high-risk breast cancer features—defined as stage III disease, triple-negative or HR−/HER2+ following neoadjuvant treatment, metastatic breast cancer without evidence of disease, bilateral breast cancer history, high-risk genetics (BRCA1/BRCA2 mutations), <40 years old at diagnosis, or history of breast cancer recurrence—were offered tumor-informed ctDNA assays at 3- to 6-month intervals. Analysis was conducted on 67 cases with a mean diagnostic age of 52.69 at diagnosis. The cohort was ethnically diverse, including White ( n = 21, 31.82%), Japanese ( n = 15, 22.73%), Native Hawaiian ( n = 11, 16.67%), and Filipino ( n = 7, 10.61%) patients. Seven (10.45%) tests were positive: six predicted recurrence despite four with initially negative radiological findings, and one prompted treatment resumption following prior non-adherence. However, one negative result was false and later showed a contralateral breast recurrence, and another negative test coincided with a new primary cholangiocarcinoma. In two cases, ctDNA negativity was utilized to monitor treatment response in metastatic disease and inform therapeutic adjustments. In real-world settings, ctDNA served as a valuable tool for earlier recurrence prediction, expediting radiological confirmation, and influencing treatment. Nevertheless, false results carry the risk of hindering effective care and inducing considerable patient anxiety. Future large-scale studies are warranted in high-risk breast cancer populations to evaluate ctDNA’s impact on patient survival outcomes, treatment monitoring, and patients’ emotional experiences.https://doi.org/10.1177/17588359251351121 |
| spellingShingle | Kasen Wong Alyssa Kameoka Jami Aya Fukui Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series Therapeutic Advances in Medical Oncology |
| title | Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series |
| title_full | Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series |
| title_fullStr | Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series |
| title_full_unstemmed | Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series |
| title_short | Exploring the utility of ctDNA testing in high-risk breast cancer patients in a community setting: case series |
| title_sort | exploring the utility of ctdna testing in high risk breast cancer patients in a community setting case series |
| url | https://doi.org/10.1177/17588359251351121 |
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