In 28 patients with estrogen receptor positive (ER+) and BCL-2 (estrogen responsive gene responsible for survival which is overexpressed in 80% of primary ER+ breast cancer), positive metastatic breast cancer (MBC) treated with tamoxifen and venetoclax (BCL-2 inhibitor) treatment responses were shown to correlate with serial changes in ctDNA in plasma. This evidence concerns the gene ESR1 and breast carcinoma.