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Liquid biopsy and breast cancer - availability and insurance
I'm currently moving from lumpectomy to treatment for ER+ breast cancer (IDC stage 1, 18mm, no node involvement), and have been doing research in preparation for having to make decisions on chemo, radiation, and hormone therapy.
At 63, with no kids, my ideal scenario (in my head) would be to avoid all three if possible. Probably a pipe dream but I have never had any real health issues, food and exercise and happiness have been my medicine, and so any sort of drug just throws me for a loop. Even taking an ibuprofen for soreness almost makes me sick. I wish I could just monitor myself like crazy through the years to come, using all the tools available to me, and if anything arises, deal with it.
Has anyone undergone liquid biopsy? It's not even been brought up by my medical team, and I didn't even know of its existence until stumbling over it on PubMed. There's a lot they haven't brought up that I had to research and insist on myself, but that's another post.
What are the monitoring tools available to me? I have a science background and already often go get my own lab work and MRIs through independent labs, so I'm used to all of that.
Sorry if this is a weird question!! I'm really not trying to bury my head in the sand, just wanting to avoid things that do more harm than good in terms of quality of life.
Thanks, and love to all.
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Sorry, I just realized the link may not open the entire article unless you are a subscriber. Many public libraries will carry The New Yorker. Some libraries also provide digital access to journals and magazines like the New Yorker, though they probably will not provide immediate access to such a very recent issue.
Thanks Barb25 for posting. I haven't had time to dive into the research literature on liquid biopsy for BC; hopefully by tomorrow!
I've been following articles published in CAP (College of American Pathologists) Today. This is a monthly publication for Pathology, Laboratory Medicine, and Laboratory Management that my husband who is pathologist receives. The most recent issue published in June 2025 has an article by Amy Carpenter "Tumor marker testing in body fluids calls for caution". Here is the complete citation:
Carpenter, A. (2025). Tumor marker testing in body fluids calls for caution. CAP Today., June, pp 5-8.
This article explains that there are few FDA-approved or cleared methods for so-called liquid biopsies or body fluid testing. Body fluid testing, by the way, does not refer in this article to serum (blood). You probably know about the CA125 ovarian cancer biomarker. The fluid for that biomarker is found in the lining of the female reproductive tract, cerfix and the abdominal mesothelium. CA 125 can be elevated in serous fluid (blood) even where there is no malignancy. So you can see why some oncologists do not place as much emphasis on CA125 testing. There is also a biomarker called CA 19-9 for pancreatic ductal carcinoma. It's all pretty complicated. Ultimately it's the lab that tests and analyzes the fluid that is critical. There are many steps involved before analysis and these steps must be validated by the lab. Every lab is required to have a written procedure that has already been carefully tested and validated.
Since blood tests are used for so many things like levels of cholesterol, kidney function, liver function and so on I'd like to think a blood test could also tell my doctor whether or not I have a malignancy. From what I have been reading a blood test or the extraction of body fluid for testing for malignancies is not that straightforward.
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1 ReactionYou might look into Signatera liquid biopsy. It checks for your particular tumor cells in your blood. I’m tested every three months. Signatera: 1 (650) 489-9050. Wishing for you the best. Onco type tells you whether or not chemo would be helpful for you. ❤️💕❤️
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1 ReactionI have ductal carcinoma insitu, stage 0. Grade 2. I was advised radiation and tamoxifen. I am afraid of both. Thinking double mastectomy to avoid radiation. I have asthma and worry about my blood/bone marrow. I did have a stereotactic biopsy, and have concerns about that. I have read that cancer cells can be released during the procedure. I get your feelings on all these decisions. I feel the same way. I was never given a oncotype number.