Dynamic ctDNA-MRD in breast cancer: subtype-specific implications for perioperative decision-making, postoperative surveillance, and MRD-guided therapy.
- 1Department of Breast Surgery, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Province, China.
- 2Department of Breast Surgery, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu Province, China. [email protected].
Abstract
Circulating tumor DNA-based molecular residual disease (ctDNA-MRD) provides prognostic information in early breast cancer, but its detection performance and clinical interpretation differ across molecular subtypes. This review examines subtype-specific ctDNA clearance, molecular re-emergence, and implications for neoadjuvant response assessment, postoperative surveillance, and MRD-directed trials. In ER-positive/HER2-negative disease, low shedding and late recurrence limit the negative predictive value of a single negative result, while the clinical utility of extended monitoring remains unproven. In HER2-positive disease, rapid clearance during neoadjuvant therapy may complement pathological complete response and residual cancer burden but does not independently determine adjuvant treatment. In triple-negative breast cancer, higher detectability and early recurrence strengthen the association between persistent or re-emergent ctDNA and short-term relapse risk. Across subtypes, ctDNA-MRD should complement clinicopathological and imaging assessment rather than independently guide treatment. Standardized assays and randomized intervention trials are required before routine clinical implementation.
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BibTeX
@article{jiao2026dynamic,
title = {{Dynamic ctDNA-MRD in breast cancer: subtype-specific implications for perioperative decision-making, postoperative surveillance, and MRD-guided therapy.}},
author = {Fuzhi Jiao and Xueyan Liu and Rong Shi and Xueqian Feng and Xiaocheng Cheng and Mingxuan Zhang and Bin Pan},
journal = {World journal of surgical oncology},
year = {2026},
month = aug,
doi = {10.1186/s12957-026-04518-w},
url = {https://europepmc.org/article/MED/42958365},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Dynamic ctDNA-MRD in breast cancer: subtype-specific implications for perioperative decision-making, postoperative surveillance, and MRD-guided therapy.
AU - Fuzhi Jiao
AU - Xueyan Liu
AU - Rong Shi
AU - Xueqian Feng
AU - Xiaocheng Cheng
AU - Mingxuan Zhang
AU - Bin Pan
PY - 2026
DA - 2026/08/03
JO - World journal of surgical oncology
DO - 10.1186/s12957-026-04518-w
UR - https://europepmc.org/article/MED/42958365
AB - Circulating tumor DNA-based molecular residual disease (ctDNA-MRD) provides prognostic information in early breast cancer, but its detection performance and clinical interpretation differ across molecular subtypes. This review examines subtype-specific ctDNA clearance, molecular re-emergence, and implications for neoadjuvant response assessment, postoperative surveillance, and MRD-directed trials. In ER-positive/HER2-negative disease, low shedding and late recurrence limit the negative predictive value of a single negative result, while the clinical utility of extended monitoring remains unproven. In HER2-positive disease, rapid clearance during neoadjuvant therapy may complement pathological complete response and residual cancer burden but does not independently determine adjuvant treatment. In triple-negative breast cancer, higher detectability and early recurrence strengthen the association between persistent or re-emergent ctDNA and short-term relapse risk. Across subtypes, ctDNA-MRD should complement clinicopathological and imaging assessment rather than independently guide treatment. Standardized assays and randomized intervention trials are required before routine clinical implementation.
SN - 1477-7819
ER -