Cell-free DNA (cfDNA) detected in blood was initially described in 1948. This cfDNA presumably originates from cellular shedding. Since its discovery and subsequently driven by the advances in the measurement of circulating viral nucleic acids from HIV pandemic and other chronic viral diseases, shedded cell-free DNA fragments have been used in a number of technologies ranging from pre-natal genetic screening and diagnosis, genomic medicine, cancer susceptibility and tumor dynamics assessments. Circulating tumor DNA (ctDNA) is a fraction of the total cfDNA. ctDNA assays are examples of what is currently called liquid biopsy, in which a sample of peripheral blood from a cancer patient is analyzed with the aim of detecting relevant tumoral information that could help individual clinical management.

More recently, tumor-informed circulating tumor DNA (ctDNA) assays have emerged with the potential to offer higher test sensitivity, allowing early cancer detection, persistence, and recurrence, potentially enabling the development of therapeutic strategies to intercept disease course. Evidence to support potential clinical utility progressively accumulates. In this very rapidly evolving field, this Research Topic aims to review and explore the field of liquid biopsies in breast cancer, with a focus on ctDNA. Articles would explore technical features, similarities, and differences, established evidence and ongoing efforts; Where we are, and where do we go from here.

We welcome the submission of original research, reviews, mini-reviews, and perspective manuscripts covering a wide range of areas, including but not limited to:
1. Definitions – evolving science and nomenclature for clinicians
2. ctDNA validated and emerging methods
3. Tumor informed vs non-informed ctDNA assays
4. Pre-analytical considerations, DNA analysis and clinical interpretation
5. ctDNA bioinformatics
6. Sensitivity and specificity considerations
7. Required/desired accuracy for clinical use
8. Test performance vs subtype of breast cancer, disease staging and treatment context.
9. Testing frequency vs clinical scenario
10. Importance of Clonal hematopoiesis of indeterminate potential detection in ctDNA from breast cancer patients
11. Diagnostic applications (screening of general population of or high-risk individuals, prognosis, therapy selection, response to therapy prediction and measurement, detection of minimal residual disease - MRD/on-treatment and post-treatment monitoring)
12. ctDNA and tumor evolution.
13. ctDNA kinetics: systemic therapy (cytotoxic therapy, targeted agents, immunotherapy, endocrine therapy), radiation therapy, surgery
14. ctDNA in systemic vs local breast cancer recurrence
15. ctDNA in benign and in pre-malignant conditions
16. ctDNA in therapeutic clinical trials
17. Quality of life of patients with or without ctDNA testing results
18. Test results management
19. Regulatory considerations/FDA device clearance through 510(k), de novo classification request, and pre-market submissions.

Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal.

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Frontiers in Oncology

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