---
title: "Circulating tumour DNA as a prognostic biomarker in advanced breast cancer: systematic review and"
id: "pubmed-42804029"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42804029"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42804029/"
doi: "10.1007/s10549-026-08087-0"
published_at: "2026-09-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Circulating tumour DNA as a prognostic biomarker in advanced breast cancer: systematic review and
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42804029
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42804029/)
- **DOI:** [10.1007/s10549-026-08087-0](https://doi.org/10.1007%2Fs10549-026-08087-0)
- **Published At:** 2026-09-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This systematic review and meta-analysis assessed the prognostic value of **circulating tumour DNA (ctDNA)** in patients with advanced breast cancer (ABC). - The literature search covered Medline, Embase, and Cochrane through 07/02/2025. - Sixty-four studies met inclusion criteria and were grouped for analysis. - Elevated baseline **ctDNA** was associated with shorter **progression-free survival (PFS)** (n = 2,586; pooled HR = 2.0; 95% CI: 1.8–2.3) and shorter **overall survival (OS)** (n = 2,454; pooled HR = 2.6; 95% CI: 2.1–3.3). - Unfavourable longitudinal changes in **ctDNA** were associated with reduced PFS (n = 710; pooled HR = 2.5; 95% CI: 1.9–3.4) and reduced OS (n = 154; pooled HR = 2.4; 95% CI: 1.5–3.8). - Study quality was assessed using the Quality in Prognosis Studies (QUIPS) tool. - The authors conclude that ctDNA shows prognostic associations with PFS and OS in ABC, suggesting potential clinical relevance for monitoring and risk stratification. - Additional details reported in the source (for example further subgroup analyses, exact methodology, and some reported findings) were truncated in the provided text and are therefore not available here.
## Clinical Analysis & Structured Key Points
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Circulating tumour DNA and its clinical relevance in predicting progression-free survival and overall survival in patients with advanced breast cancer: a systematic review and meta-analysis [Cæcilie Ottosen](https://pubmed.ncbi.nlm.nih.gov/?term=Ottosen+C&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-1 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. caeott@rm.dk.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-2 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. caeott@rm.dk."), [Ea Kragelund](https://pubmed.ncbi.nlm.nih.gov/?term=Kragelund+E&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Mette Abildgaard Pedersen](https://pubmed.ncbi.nlm.nih.gov/?term=Pedersen+MA&cauthor_id=42804029)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-4 "Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-5 "Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark."), [Vivi Quoc Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+VQ&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-6 "Department of Oncology, Odense University Hospital, Odense, Denmark."), [Sakina Kousgaard Khan](https://pubmed.ncbi.nlm.nih.gov/?term=Khan+SK&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Helene Borup Larsen](https://pubmed.ncbi.nlm.nih.gov/?term=Larsen+HB&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark."), [Anders Lerche Møller](https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%B8ller+AL&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-8 "Steno Diabetes Centre Aarhus, Central Denmark Region, Aarhus, Denmark.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-9 "Department of Radiology, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark."), [Sofie Høier Gamborg-Kvist](https://pubmed.ncbi.nlm.nih.gov/?term=Gamborg-Kvist+SH&cauthor_id=42804029)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-10 "Department of Oncology, Lillebaelt Hospital, Vejle, Denmark.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-11 "Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark."), [Karen-Lise Garm Spindler](https://pubmed.ncbi.nlm.nih.gov/?term=Spindler+KG&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark."), [Anne Sofie Brems-Eskildsen](https://pubmed.ncbi.nlm.nih.gov/?term=Brems-Eskildsen+AS&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Louise Bach Callesen](https://pubmed.ncbi.nlm.nih.gov/?term=Callesen+LB&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#full-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.") Affiliations Expand ### Affiliations * 1 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. caeott@rm.dk. * 2 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. caeott@rm.dk. * 3 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. * 4 Department of Pathology, Aarhus University Hospital, Aarhus, Denmark. * 5 Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark. * 6 Department of Oncology, Odense University Hospital, Odense, Denmark. * 7 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. * 8 Steno Diabetes Centre Aarhus, Central Denmark Region, Aarhus, Denmark. * 9 Department of Radiology, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark. * 10 Department of Oncology, Lillebaelt Hospital, Vejle, Denmark. * 11 Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. # Contributed equally. * PMID: **42804029** * DOI: [ 10.1007/s10549-026-08087-0 ](https://doi.org/10.1007/s10549-026-08087-0) Item in Clipboard Meta-Analysis # Circulating tumour DNA and its clinical relevance in predicting progression-free survival and overall survival in patients with advanced breast cancer: a systematic review and meta-analysis Cæcilie Ottosen et al. Breast Cancer Res Treat. 2026. Show details Display options Display options Format Abstract PubMed PMID Breast Cancer Res Treat Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Breast+Cancer+Res+Treat%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Breast+Cancer+Res+Treat%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42804029/) . 2026 Sep 28;219(3):23. doi: 10.1007/s10549-026-08087-0. ### Authors [Cæcilie Ottosen](https://pubmed.ncbi.nlm.nih.gov/?term=Ottosen+C&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-1 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. caeott@rm.dk.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-2 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. caeott@rm.dk."), [Ea Kragelund](https://pubmed.ncbi.nlm.nih.gov/?term=Kragelund+E&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Mette Abildgaard Pedersen](https://pubmed.ncbi.nlm.nih.gov/?term=Pedersen+MA&cauthor_id=42804029)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-4 "Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-5 "Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark."), [Vivi Quoc Nguyen](https://pubmed.ncbi.nlm.nih.gov/?term=Nguyen+VQ&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-6 "Department of Oncology, Odense University Hospital, Odense, Denmark."), [Sakina Kousgaard Khan](https://pubmed.ncbi.nlm.nih.gov/?term=Khan+SK&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Helene Borup Larsen](https://pubmed.ncbi.nlm.nih.gov/?term=Larsen+HB&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark."), [Anders Lerche Møller](https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%B8ller+AL&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-8 "Steno Diabetes Centre Aarhus, Central Denmark Region, Aarhus, Denmark.")[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-9 "Department of Radiology, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark."), [Sofie Høier Gamborg-Kvist](https://pubmed.ncbi.nlm.nih.gov/?term=Gamborg-Kvist+SH&cauthor_id=42804029)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-10 "Department of Oncology, Lillebaelt Hospital, Vejle, Denmark.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-11 "Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark."), [Karen-Lise Garm Spindler](https://pubmed.ncbi.nlm.nih.gov/?term=Spindler+KG&cauthor_id=42804029)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark."), [Anne Sofie Brems-Eskildsen](https://pubmed.ncbi.nlm.nih.gov/?term=Brems-Eskildsen+AS&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark."), [Louise Bach Callesen](https://pubmed.ncbi.nlm.nih.gov/?term=Callesen+LB&cauthor_id=42804029)[#](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-3 "Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42804029/#short-view-affiliation-7 "Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.") ### Affiliations * 1 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. caeott@rm.dk. * 2 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. caeott@rm.dk. * 3 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. * 4 Department of Pathology, Aarhus University Hospital, Aarhus, Denmark. * 5 Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark. * 6 Department of Oncology, Odense University Hospital, Odense, Denmark. * 7 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. * 8 Steno Diabetes Centre Aarhus, Central Denmark Region, Aarhus, Denmark. * 9 Department of Radiology, Aarhus University Hospital, Central Denmark Region, Aarhus, Denmark. * 10 Department of Oncology, Lillebaelt Hospital, Vejle, Denmark. * 11 Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. # Contributed equally. * PMID: **42804029** * DOI: [ 10.1007/s10549-026-08087-0 ](https://doi.org/10.1007/s10549-026-08087-0) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Purpose:** Treatment strategies for advanced breast cancer (ABC) are rapidly evolving, but treatment decisions and monitoring remain dependent on imaging-based assessments. Circulating tumour DNA (ctDNA) has emerged as a minimally invasive biomarker with potential to provide real-time assessments, yet its clinical relevance in ABC has not been established. This systematic review and meta-analysis evaluates the prognostic value of ctDNA in ABC. **Methods:** Medline, Embase, and Cochrane databases were systematically searched up to 07/02/2025. Eligible studies analysed associations between ctDNA and progression free survival (PFS) and/or overall survival (OS) in patient with ABC. Study quality was assessed using the Quality in Prognosis Studies Tool. Hazard ratios (HR) with 95% confidence intervals (CI) were extracted, and meta-analyses were performed using random-effects models. **Results:** Sixty-four studies were included and divided into subgroups. Elevated ctDNA levels at baseline were significantly associated with shorter PFS (n = 2,586, pooled HR = 2.0; 95% CI: 1.8-2.3) and OS (n = 2,454, pooled HR = 2.6; 95% CI: 2.1-3.3). Unfavourable changes in ctDNA levels were associated with reduced PFS (n = 710, pooled HR = 2.5; 95% CI: 1.9-3.4) and OS (n = 154, pooled HR = 2.4; 95% CI: 1.5-3.8). Additionally, ana
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