Some Breast Cancer Patients May Not Need Surgery if They Have Strong Chemotherapy Response

Early stage breast cancer patients often go through chemotherapy, surgery, and radiation to treat their cancers and hopefully stave off recurrence. A new study finds that for some, however, the middle step may not be necessary.

Results of a Phase II trial conducted by researchers at The University of Texas MD Anderson Cancer Center, published in the journal Lancet Oncology, showed that for patients with a complete response to chemotherapy, forgoing surgery did not translate to higher odds of recurrence.

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Dr. Henry Kuerer, lead author and professor of breast surgical oncology, says, “The ultimate form of breast-conserving therapy is completely eliminating breast surgery for invasive disease. This research adds to growing evidence showing that newer drugs can completely eradicate cancer in some cases, and very early results show we can safely eliminate surgery in this select group of women with breast cancer.”

The 50 women in this trial included patients over 40 with early stage triple-negative or HER2-positive breast cancer and a residual breast lesion smaller than two centimeters following chemotherapy. For those who had no sign of disease with a biopsy, surgery was skipped, and the patients went straight to radiation treatment. This included 31 of the participants.

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After a median followup period of just over 26 months, recurrence had not occurred in any of these patients who had had a complete chemotherapy response. There is hope that this could change things for some patients in the years ahead. However, the trial was small, and more research over a longer period of time is needed.

Dr. Kuerer explains, “For the time being, standard breast cancer surgery is still necessary. While these results are remarkable and quite promising, it’s important for patients to know this is the very beginning of a new type of treatment for select patients. Much longer follow-up and further studies will be necessary before this approach can be integrated into routine breast cancer care.”

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Next up would be a larger randomized study.

This research was funded in part by the National Cancer Institute/National Institutes of Health.

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