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This debate will examine the role of circulating tumor DNA (ctDNA) testing in the adjuvant management of early-stage breast cancer outside of clinical trials. Faculty will explore the potential clinical value of ctDNA for detecting minimal residual disease, guiding treatment escalation or de-escalation and informing prognosis. The discussion will also address limitations of current evidence, assay variability, and ethical and practical considerations. Session presenters will give their expert perspective on whether and how ctDNA testing should be integrated into routine adjuvant care. Current limitations in evidence, including uncertainty around clinical actionability, impact on outcomes, and optimal management of positive results, define the conversation around the use of ctDNA in cancer therapy. This discussion will address concerns related to assay variability, false positives, cost, and patient anxiety, and explore why ctDNA testing may be best reserved for investigational settings until prospective data clarify its role.