How do you approach early-stage breast cancer patients who are asking for ctDNA or tumor marker surveillance (or previously receiving these with another provider) when these are not part of the NCCN or ASCO guidelines?  

In regards to tumor markers, I admit that I follow these in some of my higher-risk (high-risk stage IIB-IIII) patients, despite ASCO and Choosing Wisely guidelines not to do so but am not willing to send these in lower-risk (stage I-IIA) patients, even if they request that I do so, explaining that i...

I don’t order tumor markers; never have. However, if anyone ever orders tumor markers, they should definitely order ctDNA, as its accuracy is significantly better. In reference to “early” breast cancer, this depends on risk, TNBC, Oncotype, etc. Then, ordering a test that has a hig...