Pfister Kerstin, Huesmann Sophia, Fink Angelina, Friedl Thomas W P, Mergel Franziska, Schäffler Henning P, Hartkopf Andreas, Lukac Stefan, Veselinovic Kristina, Mehmeti Forca, Campbell Nathan, Pipinikas Christodoulos, Deininger Katharina, Beer Ambros, Lorenz Stefanie, Beer Meinrad, Wiesmüller Lisa, Janni Wolfgang, Heublein Sabine, Rack Brigitte
Department of Gynecology and Obstetrics, University Hospital Ulm, 89075 Ulm, Germany.
Department of Gynecology and Obstetrics, SLK-Kliniken Heilbronn, 74078 Heilbronn, Germany.
Int J Mol Sci. 2025 Sep 1;26(17):8498. doi: 10.3390/ijms26178498.
Current aftercare after early breast cancer overlooks recent evidence on circulating free tumor DNA (ctDNA). In this case report, we present a patient with low-risk hormone-receptor-positive breast cancer. ctDNA was first detected using a tumor-informed approach 12 months after the initial diagnosis and remained positive throughout adjuvant therapy with letrozole, while routine staging examinations showed no signs of relapse. Clinical relapse was ultimately identified nearly six years after the initial diagnosis, resulting in a lead time of four years and nine months. Current studies on ctDNA in the adjuvant setting have been conducted in high-risk cohorts and have shown a median molecular lead time of 8.9-12.4 months. Our study supports the need for large randomized clinical trials involving low-risk breast cancer patients to drive changes in clinical practice.
早期乳腺癌目前的后续治疗忽视了关于循环游离肿瘤DNA（ctDNA）的最新证据。在本病例报告中，我们介绍了一名患有低风险激素受体阳性乳腺癌的患者。在初次诊断后12个月，首次采用肿瘤知情方法检测到ctDNA，并且在来曲唑辅助治疗期间一直呈阳性，而常规分期检查未显示复发迹象。最终在初次诊断近六年之后确定出现临床复发，导致提前期为四年零九个月。目前关于辅助治疗中ctDNA的研究是在高风险队列中进行的，并且显示分子中位提前期为8.9 - 12.4个月。我们的研究支持有必要开展涉及低风险乳腺癌患者的大型随机临床试验，以推动临床实践的变革。
