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Breast cancer patients who respond well to pre-surgical treatment may be able to skip surgery: study

Patients diagnosed with early stage breast cancer who had a good response to targeted cancer treatment before surgery – otherwise known as adjuvant therapy – may be able to skip surgery and receive radiation therapy, with a low risk of cancer recurrence.

According to a new study by researchers from The University of Texas MD Anderson Cancer Center, one of the most respected centers in the world devoted exclusively to cancer patient care and research.

“This research adds to the growing evidence showing that new drugs can completely eradicate cancer in some cases, and the very first results show that we can safely eliminate surgery in this select group of women with breast cancer. breast,” lead researcher Henry Kuerer, MD, Ph.D., said in a statement.

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He is a professor of surgical breast oncology at the University of Texas MD Anderson Cancer Center in Houston, Texas.

The results of the phase II trial have been published in Lancet Oncology.

“This research adds to the growing evidence showing that new drugs can completely eradicate cancer in some cases, and the very first results show that we can safely eliminate surgery in this select group of women with breast cancer. breast,” said lead researcher Henry Kuerer, MD, Ph.D.
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The researchers examined the likelihood of breast cancer recurrent in patients considered to be in complete remission after receiving chemotherapy and radiotherapy without surgery.

Thirty-one of the 50 patients who were followed had a complete response to chemotherapy – and none had a breast tumor recurrence after a median follow-up of 26.4 months, according to the study.

Patients received specific cancer-targeting treatments and chemotherapy before surgery.

“These types of breast cancer usually come back in [the] early years, so [the] a short follow-up showed promising results,” Dr. Kuerer told Fox News Digital in an interview about the study.

Patients received specific cancer-targeting therapies and chemotherapy before surgery, Keurer told Fox News Digital.

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“Patients often have surgery first, but these targeted therapies increase survival. So give it first – it shrinks tumors, allowing lumpectomy versus mastectomy,” he said in an interview. .

The multicenter study involved 50 women over the age of 40 with early-stage triple-negative or HER2-positive breast cancer and residual breast lesion of less than 2 centimeters after standard chemotherapy treatment.

If cancer was not detected on biopsy, breast surgery was not performed and patients received standard radiotherapy.

Patients underwent image-guided vacuum-assisted core biopsy (VACB).

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If cancer was not detected on biopsy, breast surgery was not performed and patients received standard radiotherapy.

Of the participants, the VACB identified 31 patients as having a pathological complete response, which means that a pathologist does not detect cancer in the tissue where the tumor was.

"Although 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," said lead researcher Henry Kuerer, MD, Ph.D., of the new study.

“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,” said lead researcher Henry Kuerer, MD, Ph. .D., about the new study.
(Stock)

“Patients who had a good response to treatment and evidence on imaging that the tumor was responding well — instead of operating, we used imaging biopsy and skipped surgery in these patients,” Kuerer said.

He also explained that the high response rates, combined with selective image-guided VACB and rigorous histological processing (study of tissues and cells), have improved doctors’ ability to determine patients who may not need of surgery.

He said the biopsy protocol designed by the MD Anderson Clinic has proven to be quite accurate in the researchers’ previous research.

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“We designed, tested and implemented the technique in 2018 and found 98% accuracy in this biopsy protocol,” he said.

Kuerer also warned that more research is needed before this process becomes the standard of care.

Dr Keurer's team at the University of Texas MD Anderson Cancer Center noted that this is a small, non-randomized study - and that larger randomized studies are needed before changes to the standard of treatment can be considered.

Dr Keurer’s team at the University of Texas MD Anderson Cancer Center noted that this is a small, non-randomized study – and that larger randomized studies are needed before changes to the standard of treatment can be considered.
(REUTERS/Jim Bourg)

“At the moment, standard breast cancer surgery is still needed,” Kuerer said.

“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.”

He added: “Many longer follow-up and further studies will be needed before this approach can be integrated into routine breast cancer care.”

Keurer said researchers will continue to follow these patients to monitor their long-term outcomes.

His team noted that this is a small, non-randomized study – and that larger randomized studies are needed before changes to the standard of care can be considered.

“It’s a very interesting and challenging essay.”

“This is a very interesting and challenging trial,” Sarah P. Cate, MD and director of the Breast Surgery Quality Program at Mount Sinai Health System in New York City, told Fox News Digital.

“Nationally, there are a few clinical trials aimed at avoiding breast cancer surgery,” said Cate, who was not involved in the study.

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“However, long-term follow-up is needed for these trials to be extrapolated to all breast cancer patients and for us to know it is safe to offer them.”

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Added Cate, who is also director of the special surveillance and breast program at Mount Sinai Health System, “This trial also had a very small number of patients who were treated without surgery. Changes to the standard of care would involve a much larger trial with many more patients.”

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