Modern medicine has many tools that can be used to fight breast cancer. When appropriate, surgery to excise the tumor is one of the most important steps in the treatment of cancer.
A new study suggests that surgery may not be necessary for every patient. The study found that a group of patients who responded well to treatment could skip surgery.
Fifty patients over 40 years old with two types of breast cancer and early-stage disease were included in the trial.
All patients had their tumors looked at to see if they had responded well to the treatment. Sixty percent of the patients responded well and were able to avoid surgery.
Dr. Henry Kuerer, the principal investigator of the study, said that after two years and two months, the participants were still free of cancer.
He said the elimination of surgery is the ultimate form of breast-conserving therapy.
Breast surgery can lead to infections, scars, and even breast-conserving procedures can change the shape of the breast.
There is progress in the field Research has changed the way cancer is treated. Some recent updates are listed here.
Cancer of the uterus. According to new findings from a national study, women who use chemical hair straighteners frequently have a higher risk of developing uterine cancer than women who have never used the products.
A vaccine for cancer. The promise of cancer vaccines that would protect healthy people at high risk of cancer has been dangled in front of researchers. Encouraging animal data and preliminary studies in humans are making some doctors feel better.
There is a Tumor Microbiome There are two new studies that show that cancer is rife with organisms. Some scientists hope to find early signs of hidden tumors by measuring the microbes in the blood that shed into the blood.
A trick that can be used to detect something. Researchers discovered that cells from some types of cancers were able to hide from the immune system. Some cancers can be resistant to treatments that should have killed them.
Cancer of the rectal area. A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result.
There are always people who would rather not have surgery for breast cancer.
He noted that some patients prefer radical surgery even if it doesn't improve survival, while others prefer a minor procedure to remove the tumors.
An approach to cancer treatment called de-escalation is an effort to individualize treatment to a specific type of cancer, achieving the same results with less treatment and fewer interventions.
Some women with breast cancer can forgo treatment if a test shows that it won't help and other drugs are available, sparing them both short- and long-term effects. Breast-conserving lumpectomy is part of de-escalation, as is forgoing surgery entirely. Dr. Kuerer is looking at whether radiation is always necessary.
The study asks a bold question: How do we take all the advances that we've made in more tailored and specific cancer therapy and convert that to reducing the number and types of interventions any one patient needs to incur?
It's reasonable to ask if we can scale back surgery.
After finding a small lump near her breast bone, Pamela Romero traveled from her home in New Iberia, La., to MD Anderson to get a second opinion. Her tumor was large and positive for HER2.
Human epidermal growth factor 2 is found in a HER2 positive tumor. Only women with HER2 positive tumors and triple-negative tumors that have cells that do not respond to hormones were included in the trial.
The doctor asked how she felt about surgery and she said she was scared to death. I want to get rid of the cancer without having surgery.
She didn't want to go under the knife or be put under anesthesia.
The doctor told Ms. Romero that she could not have surgery if she wanted to. The regimen was completed after two more treatments.
Ms. Romero has been disease-free for three years after undergoing treatment.
The surgery-free regimen appears to have been successful, but only a small number of carefully screened women have been followed for 26 months.
Specific types of cancer that are studied tend to recur within the first few years. A larger trial with a comparison group is needed to see if changes are necessary.
The chief of breast surgery at a New York hospital said that the study was a tiny one. It's not a conclusive thing. It won't alter practice.
She said that the patients in the trial had small tumors and would have qualified for breast-conserving lumpectomies.
She said that the surgery was an hour long. It is possible to get it done and you will have some pain. She said that women who get lumpectomies wouldn't have been a good candidate for major surgeries.
The patients in the trial who were able to skip surgery had to have their tissue samples analyzed to see if they had any signs of cancer. Those who had a complete response to the drug were allowed to delay surgery.
60 percent to 80 percent of patients with triple-negative or HER2 positive breast tumors are able to avoid surgery thanks to improved Chemo agents. There are strict protocols that must be followed to achieve high levels of accuracy in certain image-guided biopsies.
The results of the new trial were promising, but Dr. Kuerer warned that surgery was still needed for most breast cancer patients. This is the beginning of a new type of treatment for some patients.
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