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Elimination of Surgery Explored for Selected Breast Cancer Patients

Last Updated: October 27, 2022.

THURSDAY, Oct. 27, 2022 (HealthDay News) -- For highly selected patients with breast cancer, eliminating surgery may be feasible for neoadjuvant systemic therapy (NST) responders identified with an image-guided vacuum-assisted core biopsy (VACB), according to a study published online Oct. 25 in The Lancet Oncology.

Henry M. Kuerer, M.D., from The University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a multicenter phase 2 trial in seven centers in the United States involving women aged 40 years or older with unicentric cT1-2N0-1M0 triple-negative breast cancer or human epidermal growth factor receptor 2 (HER2)-positive breast cancer and a residual breast lesion less than 2 cm on imaging after clinically standard NST. Patients had one biopsy obtained by 9G image-guided VACB of the tumor bed; breast surgery was omitted if no invasive or in-situ disease was identified, and patients underwent standard whole-breast radiotherapy plus a boost.

Fifty patients underwent VACB following NST: 21 and 29 had triple-negative and HER2-positive breast cancer, respectively. The researchers found that VACB identified 31 patients (62 percent) with a pathological complete response. No ipsilateral recurrences occurred in these patients at a median follow-up of 26.4 months. There were no serious biopsy-related adverse events or deaths related to treatment reported.

"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," Kuerer said in a statement. "Much longer follow-up and further studies will be necessary before this approach can be integrated into routine breast cancer care."

Several authors disclosed financial ties to the biopharmaceutical and publishing industries.

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