Cancer type
Breast
Breast cancer updates on ctDNA surveillance and molecular residual disease after definitive therapy.
A JAMA Oncology analysis published online August 13, 2026, of 1,026 plasma samples from 159 patients in the c-TRAK TN surveillance cohort found that tissue-free ctDNA detection was associated with recurrence (HR 27.2; 95% CI 13.7 to 54.2), and median lead time to recurrence was 7.6 months with the tissue-free assay versus 7.1 months with a multivariant tumor-informed assay.
JAMA Oncology
The MolDX billing article A58434, in the revision effective January 1, 2026, lists Signatera for neoadjuvant breast cancer and lists NeXT Personal, Pathlight, RaDaR, and Signatera for recurrence or relapse testing in advanced breast cancer.
CMS MolDX
In the NeoCircle analysis of 116 patients with stage I to III breast cancer presented at ASCO 2025, postoperative molecular residual disease detected with a tumor-informed structural-variant assay was associated with a shorter relapse-free interval (HR 45.5; 95% CI 13.0 to 159.8) and shorter overall survival (HR 15.3; 95% CI 4.5 to 52.9).
Journal of Clinical Oncology
In the phase 3 ZEST trial, reported at SABCS 2024, enrollment stopped early after 1,901 patients had a tumor-informed ctDNA result and only 40 were randomized; of 147 patients with ctDNA detected, 72 (49%) already had radiographic recurrence on staging before randomization.
Clinical Cancer Research