Elimination of explored surgery for some breast cancer patients

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

Henry M. Kuerer, MD, of the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a multicenter Phase 2 trial at seven centers in the United States involving women aged 40 or older with cT1 -2N0-1M0 unicentric triple-negative breast cancer or human epidermal growth factor receptor 2 (HER2) positive breast cancer and residual breast lesion less than 2 cm on imaging after clinically standard NST. Patients had a 9G image-guided VACB biopsy 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 booster.

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

“While these results are remarkable and quite promising, it is important for patients to know that this is the very beginning of a new type of treatment for some patients,” Kuerer said in a statement. “Much longer follow-up and further studies will be needed before this approach can be incorporated into routine breast cancer care.”

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

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