Two New Publications Examine Important Questions in Breast and Ovarian Cancer Care
Cancer research does not only pursue new treatments. It also examines how emerging technologies may improve monitoring, how existing approaches compare, and how clinicians can make more informed decisions for individual patients.
Two recently published articles coauthored by Women’s Cancer Research Foundation Founder and Chairman John P. Micha, M.D., and President and Senior Clinical Fellow Bram Goldstein, Ph.D. explore questions currently shaping breast and ovarian cancer care. The first considers the potential role of molecular residual disease testing in monitoring early-stage breast cancer. The second reviews evidence comparing two surgical approaches used in advanced-stage ovarian cancer.
Molecular Residual Disease Testing in Early-Stage Breast Cancer
Molecular residual disease testing uses circulating tumor DNA, or ctDNA, to look for traces of cancer that may remain in the body following treatment. This developing technology may allow disease progression to be identified earlier than it would be through conventional monitoring.
However, detecting cancer-related DNA earlier also raises an important question: What should happen when a test is positive, but a patient has no symptoms or other evidence of recurrence?
The recently published review examines both the potential clinical value of this technology and the questions that remain.
Micha JP, Bohart R, Goldstein BH. The clinical utility of molecular residual disease testing in early-stage breast cancer. Expert Rev Anticancer Ther. 2026 Feb 13:1-4.
Abstract
Introduction: Breast cancer is the most commonly-diagnosed malignancy among women. Currently, radiologic imaging is indicated for defined surveillance periods and to assess or corroborate patient symptomatology. More recently, the advent of circulating tumor DNA (ctDNA) assays has conferred a potential enhancement in disease monitoring via the evaluation of molecular residual disease (MRD).
Areas covered: Studies have shown that MRD testing reportedly eventuates in a lead-time predictive benefit in diagnosing progressive disease compared to traditional assessment. In particular, the Signatera test has compelling advantages compared to many of the available MRD tests, especially given the reported clinical data with MRD testing in early-stage breast cancer. In the current review, we recount the results from several studies on the topic of MRD testing in the treatment and surveillance of breast cancer.
Expert opinion: MRD testing in early-stage breast cancer theoretically confers a significant clinical benefit with adjuvant therapy and during patient surveillance. However, there are concerns with the potential for aggressive or prolonged treatment, not to mention the specific approach to managing patients who are ctDNA positive but remain asymptomatic.
Comparing Surgical Approaches in Advanced-Stage Ovarian Cancer
For women with advanced-stage ovarian cancer, surgery typically focuses on removing as much visible cancer as possible. That surgery may be performed before chemotherapy, known as primary debulking surgery, or after an initial course of chemotherapy, known as interval debulking surgery.
The most appropriate approach can depend on several factors, including whether complete removal of visible disease appears achievable and whether a patient’s age, overall health, or other medical conditions affect her ability to undergo extensive surgery.
This review compares the available evidence surrounding both approaches and the circumstances in which each may be considered.
Micha JP, Bohart RD, Gorman JP, Goldstein BH. Primary Debulking Surgery Versus Interval Debulking Surgery in the Management of Advanced-Stage Ovarian Cancer. Anticancer Res. 2026 Mar;46(3):1175-1182.
Abstract
Background/aim: The improved overall survival rates associated with advanced-stage ovarian cancer primarily reflect the surgeon's capacity to remove all residual disease following either primary debulking surgery (PDS) and chemotherapy or via neoadjuvant chemotherapy and interval debulking surgery (IDS). The aim of this study was to compare the survival rates in ovarian cancer following either PDS or IDS.
Materials and methods: We conducted an extensive PubMed search incorporating review articles, retrospective studies, and randomized control trials on the topic of ovarian cancer, with specific terms that included ovarian cancer, PDS, IDS, overall survival, and intraoperative outcomes.
Results: While several investigations have indicated that PDS and IDS confer equivalent survival outcomes, additional results suggested that PDS is associated with improved survival compared to IDS, especially in patients amenable to a gross total resection.
Conclusion: Despite the reportedly similar overall survival outcomes in ovarian cancer, IDS is indicated with elderly or frail patients and in the presence of significant co-morbidities; alternatively, PDS may be preferable in ovarian cancer cases wherein an upfront gross total resection can be readily achieved.
Research That Examines Both Promise and Complexity
Although these publications address very different areas of cancer care, they share an important theme: promising tools and treatment strategies must be evaluated alongside the complex decisions that accompany them.
Earlier detection does not eliminate questions about when or how to intervene. Likewise, comparisons between surgical approaches cannot be separated from a patient’s health, the extent of her disease, and the likelihood that visible cancer can be completely removed.
Research helps clinicians continue examining those questions, refining current approaches, and building the evidence needed to improve care for women affected by breast and ovarian cancers.
These recent publications reflect the continued commitment of Dr. John P. Micha, Bram Goldstein, Ph.D. and their fellow authors to examining the questions that influence how breast and ovarian cancers are monitored and treated. Through this work, they are helping build the evidence needed to refine current approaches and improve care for women affected by these diseases.
About the Women’s Cancer Research Foundation
The Women’s Cancer Research Foundation (WCRF) is a 501(c)(3) nonprofit organization dedicated to improving cure rates and quality of life for women with breast and gynecologic cancers. Its physicians and researchers have contributed to clinical research since 1985, including clinical trials, collaborative studies, and peer-reviewed publications focused on breast, ovarian, uterine, and cervical cancers. WCRF also provides accessible educational information about women’s cancers and advances in treatment.
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