Loay Kassem: Most Breast Cancer Patients Will Avoid Surgery in the Future
Loay Kassem, Assistant Professor of Clinical Oncology at Kasr AlAiny School of Medicine, shared a post on LinkedIn:
“In the near future, most patients with breast cancer will avoid surgery.
Breast surgery is a problem for many patients (specially mastectomy and axillary LN dissection). Many patients would love to avoid it. For decades, doctors used to say this is impossible.
Recently, with many patients receiving neoadjuvant therapy and getting complete remission (disappearance of the cancer), it might be finally possible to omit surgery.
A recent non-randomized study from 7 US cancer centers published in JAMA Oncology and included 50 women with cT1-2N0-1M0 HER2+ or TNBC who had residual breast lesions (<2cm) after neoadjuvant therapy. Those patients did extensive biopsies (Image-guided VAB of the tumor bed, 9G with a minimum of 12 cores).
Patients with no viable cancer in the breast on VAB received only whole-breast radiotherapy with a boost with NO SURGERY.
On the other hand, those with residual cancer after VAB had standard breast and axillary surgery.
The results were IMPRESSIVE.
Among the 50 patients, 31 (62%) truly had PCR. At a median follow-up of 55.4 months, the ipsilateral breast tumor recurrence rate was 0%, and disease-free and overall survival rates were 100% for patients without breast surgery.
To me, this is the time to conduct multiple large randomized studies to test this point.”
Selective Elimination of Breast Surgery for Invasive Breast Cancer
Authors: Henry M. Kuerer, Vicente Valero, et al.
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