Women’s perceptions and preferences regarding liquid biopsy for breast cancer screening.

e22548 Background: Liquid biopsy is a potential new noninvasive tool for cancer detection and may address barriers to current breast cancer screening methods. Little is known about preferences and perceptions regarding liquid biopsy among diverse populations of women. This study evaluated attitudes towards liquid biopsy for breast cancer screening that may influence its acceptance. Methods: An online survey was distributed between February 2024 and December 2025 to women aged 40–75 years without a history of invasive breast cancer enrolled in three cohorts: Mano a Mano (Mexican-American women in the Houston area), Project CHURCH (African-American women, also in Houston) and High Risk Breast Cohort (women at high breast cancer risk enrolled at MD Anderson Cancer Center). 520 participants completed a 29-item questionnaire that assessed screening preferences, barriers, and psychosocial factors. A subsample (n = 35) also completed a qualitative interview. Statistical analyses included descriptive statistics, Kruskal–Wallis, or Chi-square tests. Results: Among survey respondents, 57.8% indicated that they were extremely interested in liquid biopsy for breast cancer screening. Interest level differed across the three cohorts (p < 0.001) with the lowest proportion of extremely interested in the Mano a Mano (37%) and the highest in the High-Risk Breast cohort (62%). The most cited reason for adopting liquid biopsy was the potential to detect breast cancer earlier than current screening methods, rated as "very important" by 96% of participants in High-Risk Breast, 86% in Mano a Mano and 79% in Project CHURCH cohorts. The most cited concern was the test accuracy, rated as "very important" by 61% of participants in High-Risk Breast, 58% in Mano a Mano, and 58% in Project CHURCH cohorts. The proportion of participants who had never undergone breast cancer screening differed significantly across cohorts (p < 0.005), with Project CHURCH participants being the least likely to have had prior screening. Among those who had never undergone screening (n = 57), 80% indicated a willingness to pursue screening using liquid biopsy. Overall, 94% of participants interviewed had a positive attitude towards liquid biopsy screening. The major themes of concern elicited in qualitative interviews were its accuracy, cost, and relying on liquid biopsy as the only screening method. Conclusions: Liquid biopsy represents a promising strategy to increase breast cancer screening participation, particularly among under-screened populations. Improving accuracy, decreasing costs, and understanding how to integrate it with traditional screening methods will be needed to increase acceptance of liquid biopsy for breast cancer screening.