Francisco J. Esteva, Chief of the Division of Hematology and Medical Oncology at Lenox Hill Hospital, shared a post on LinkedIn:
“Are we detecting breast cancer earlier than we know how to treat it?
A positive liquid biopsy with a normal scan creates a real clinical dilemma.
Circulating tumor DNA can reveal tiny traces of cancer months before imaging shows anything. But earlier detection does not guarantee better outcomes. The right response to a positive result is still unclear.
Liquid biopsy is already standard in metastatic breast cancer and other solid tumors. It helps guide treatment decisions. It is also useful in early-stage colon cancer to estimate recurrence risk.
Early breast cancer is different. Patients complete treatment with curative intent. Then a blood test suggests the disease may be back, but nothing is visible.
The data are consistent for risk. They are not yet strong for action. We still lack proof that changing treatment based on these results improves survival.
This is the tension: act early without evidence, or wait while uncertainty grows.
Clear thinking matters here. Overreaction harms. False reassurance harms. The goal is to understand what the test means – and what it does not.
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