Circulating tumor DNA in early-stage triple-negative breast cancer: clinical landscape and key open challenges

Despite encouraging results, the clinical utility of ctDNA remains unproven due to technical limitations, especially in assay sensitivity, timing of testing, and low ctDNA shedding/high relapse rate in early-stage disease. Randomized trials are essential to confirm the role of ctDNA in guiding treatment de-escalation or escalation, ultimately aiming to personalize care and improve outcomes in patients with eTNBC.