De-escalating Surgery Among Patients with HER2+and Triple Negative Breast Cancer

被引:2
作者
Tasoulis, Marios-Konstantinos [1 ,2 ]
Heil, Joerg [3 ]
Kuerer, Henry M. [4 ]
机构
[1] Royal Marsden NHS Fdn Trust, Breast Surg Unit, Fulham Rd, London SW3 6JJ, England
[2] Inst Canc Res, Div Breast Canc Res, Old Brompton Rd, London SW7 3RP, England
[3] Heidelberg Univ Hosp, Univ Breast Unit, Dept Obstet & Gynecol, Heidelberg, Germany
[4] Univ Texas MD Anderson Canc Ctr, Dept Breast Surg Oncol, Houston, TX 77030 USA
关键词
Surgical de-escalation; Breast surgery; Triple negative; HER2; positive; Breast cancer; PATHOLOGICAL COMPLETE RESPONSE; SENTINEL NODE BIOPSY; 20-YEAR FOLLOW-UP; NEOADJUVANT CHEMOTHERAPY; RADICAL-MASTECTOMY; MULTICENTER; TRIAL; IDENTIFICATION; AXILLA; IMPACT;
D O I
10.1007/s12609-022-00453-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of Review De-escalation of surgery has been central in the evolution of multidisciplinary management of breast cancer. Advances in oncology and increasing use of neoadjuvant chemotherapy (NACT) have opened opportunities for further surgical de-escalation especially for HER2 + and triple negative (TN) disease. The aim of this review is to discuss the recent data on de-escalation of surgery as well as the future directions. Recent Findings Patients with TN and HER2 + breast cancer with excellent response to NACT would be the ideal candidates for surgical de-escalation. Post-NACT image-guided biopsy, potentially combined with machine learning algorithms, may accurately identify patients achieving pathologic complete response that would be eligible for clinical trials assessing safety of omission of breast and axillary surgery. Multidisciplinary research is required to further support results of preliminary studies. Current data point towards a future when even less or no surgery may be required for exceptional responders.
引用
收藏
页码:135 / 141
页数:7
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