Surgery may not be necessary for some early-stage breast cancer patients

Source: The University of Texas MD Anderson Cancer Center

From: news-medical.net

Surgery may not be the best next course of treatment for patients with early-stage breast cancer who had a complete response to neoadjuvant (pre-surgical) chemotherapy and standard radiation treatment, according to new data from researchers at The University of Texas MD Anderson Cancer Center.

Five-year results from the Phase II trial, published today in JAMA Oncology, revealed that breast cancer still had not returned in patients who had a pathologic complete response (pCR) after chemotherapy and radiation, without surgery. After a median follow-up of 55.4 months, each of the 31 patients with a pCR remained disease free, and the overall survival rate was 100%.

The findings, which also are being presented today at the Society of Surgical Oncology 2025 Annual Meeting, suggest that some patients may be able to avoid breast surgery, which has long been part of standard treatment.

This is the first modern prospective trial of surgery omission in patients with early-stage breast cancer who respond favorably to chemotherapy. It builds on data from an earlier report with a follow-up of roughly two years.

Globally, 2.3 million women receive a breast cancer diagnosis every year. For more than a century, surgery has been the standard of treatment for nonmetastatic invasive disease, but improved chemotherapy agents have increased pCR rates significantly. Combining these high response rates with selective image-guided vacuum-assisted core biopsy (VACB) and stringent histologic processing has improved physicians’ ability to determine which patients may not need surgery.

This multicenter trial enrolled 50 women over age 40 with early-stage triple-negative or HER2-positive breast cancer. The mean age of participants was 62 years; 21 patients had triple-negative breast cancer and 29 had HER2-positive breast cancer.