As chemotherapy drugs improve, so have pathologic complete response (pCR) rates for breast cancer—which, according to a new study published in Lancet Oncology, may allow some patients who respond well to chemotherapy and radiation treatments to skip surgery with a low chance of recurrence.
“The ultimate form of breast-conserving therapy is completely eliminating breast surgery for invasive disease,” principal investigator Henry Kuerer, MD, PhD, of the the University of Texas MD Anderson Cancer Center says in a news release. “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.”
In the study, a single image-guided, vacuum-assisted core biopsy (VACB) after chemotherapy treatment was used to determine which of the 50 early-stage breast cancer patients—all women aged 40-plus, with a median age of 62—could be deemed “exceptional responders.” Each of the patients in the study had either triple-negative or HER2-positive breast cancer [1].
The women whose VACB did not identify any signs of cancer—31 of 50 participants—received standard, whole-breast radiotherapy treatments without breast surgery. After follow-up at a median of 26.4 months, none of the 31 patients had breast tumor recurrence.
While the authors call the findings “promising early results,” they also note the need for additional clinical trials before coming to rely on them.
“For the time being, standard breast cancer surgery is still necessary,” Kuerer says. “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.”