Breast Cancer (Auckl). 2026 Sep 3;20:11782234261485831. doi: 10.1177/11782234261485831. eCollection 2026.

ABSTRACT

Breast cancer remains the most frequently diagnosed cancer and a leading cause of cancer-related mortality among women worldwide, underscoring the need for accurate, minimally invasive biomarkers to support precision oncology. Conventional tissue biopsy remains the standard for molecular characterization but is limited by its invasiveness, inability to capture spatial and temporal tumor heterogeneity, and challenges in serial monitoring. Circulating tumor DNA (ctDNA), a tumor-derived fraction of cell-free DNA, has emerged as a promising liquid biopsy biomarker capable of providing real-time genomic information throughout disease progression. This narrative review examines recent advances in ctDNA biology, analytical technologies, clinical applications, current limitations, and future directions in breast cancer management. A structured literature search of PubMed/MEDLINE, Scopus, Embase, Web of Science, and Google Scholar identified relevant English-language publications from 2015 to 2026. Current evidence indicates that highly sensitive platforms, including digital PCR, BEAMing, and next-generation sequencing, can detect clinically actionable alterations in genes such as PIK3CA, ESR1, TP53, ERBB2, AKT1, and BRCA1/2. ctDNA has demonstrated particular utility in identifying minimal residual disease, monitoring therapeutic response, detecting emerging resistance mechanisms, and guiding targeted treatment selection in advanced breast cancer. However, applications in early cancer detection, population screening, and artificial intelligence-assisted clinical decision-making remain investigational. Widespread clinical implementation is constrained by low ctDNA abundance in early-stage disease, analytical variability, limited assay standardization, and cost considerations. Continued technological innovation, prospective multicenter validation, standardized testing protocols, and evidence-based clinical guidelines are essential to fully integrate ctDNA into routine precision breast cancer care.

PMID:42699009 | PMC:PMC13542536 | DOI:10.1177/11782234261485831

Updates Surg. 2026 Aug 24. doi: 10.1007/s13304-026-02814-4. Online ahead of print.

ABSTRACT

Esophageal cancer (EC) remains a highly lethal malignancy, characterized by late diagnosis, early systemic dissemination, and high recurrence rates. Conventional diagnostic and surveillance strategies have limited sensitivity for early disease detection and minimal residual disease. Liquid biopsy technologies have emerged as promising minimally invasive tools for diagnosis, prognostication, and longitudinal monitoring. This scoping review summarizes current evidence on the clinical utilization of liquid biopsies in esophageal squamous cell and adenocarcinoma. PubMed, EMBASE and Cochrane Library were queried. Inclusion criteria encompassed studies investigating the use of liquid biopsy for EC diagnosis, treatment response evaluation, and prognosis definition. A total of 73 studies reported the role of circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), or microRNAs (miRNA). The majority (59%) focused on ctDNA while CTC and miRNA were assessed in 12 and 14 studies, respectively. The reported pooled diagnostic sensitivity and specificity was 71% and 98.6%, respectively, with superior performance in advanced stages (III-IV). Serial ctDNA measurements during neoadjuvant therapy have been reported useful for assessing tumor burden reduction. Additionally, comprehensive ctDNA profiling proved valuable for analysis of tumor heterogeneity and actionable genetic alterations suitable for targeted treatment therapies. Elevated preoperative ctDNA levels correlated with an increased risk of nodal metastasis and postoperative cancer recurrence. ctDNA was also identified as a useful prognostic marker, demonstrating sensitivity and specificity of 49% and 95%, respectively, for survival prediction. Despite limitations related to the various methodologies employed and the lack of laboratory standardization, liquid biopsy constitutes a promising frontier in the surgical management of EC, offering minimally invasive, real-time tool for assessing tumor genetics, genomic heterogeneity, and dynamics of tumor progression. It might enhance early diagnosis, inform neoadjuvant treatment response, and enable postoperative surveillance for residual or recurrent cancer.

PMID:42635711 | DOI:10.1007/s13304-026-02814-4