0
0
Recent studies presented at the San Antonio Breast Cancer Symposium offer promising alternatives to traditional surgeries for some early breast cancer patients, potentially reducing treatment burdens and improving patient quality of life. The research, published in two major medical journals, explores whether specific surgical procedures are always necessary for certain cases of breast cancer.
DCIS: A Wait-and-See Approach?
One study, published in the New England Journal of Medicine, focuses on a type of early-stage breast cancer known as ductal carcinoma in situ (DCIS). This non-invasive cancer occurs when abnormal cells are found in the milk ducts of the breast, but the surrounding tissue remains healthy. With about 50,000 cases diagnosed annually in the U.S., many women have traditionally opted for surgery to remove the abnormal cells. However, it has long been unclear whether surgery is always the best option, especially for low-risk cases.
The study suggests that for many women with low-risk DCIS, active monitoring could be a viable alternative to surgery. After tracking over 950 women assigned either to surgery or active monitoring for two years, researchers found that rates of invasive cancer were low and comparable between the two groups. About 6% of patients who underwent surgery and 4% of those who chose active monitoring were later diagnosed with invasive cancer.
Dr. Virginia Kaklamani, a breast cancer expert from the University of Texas Health Science Center, emphasized the significance of the findings, noting that it confirms the suspicion that some women with DCIS have been “overtreated.” However, other experts, like Dr. Monica Morrow from Memorial Sloan Kettering Cancer Center, cautioned that two years may not be long enough to make definitive conclusions.
Tina Clark, a 63-year-old participant in the study, shared her experience of being randomly assigned to the monitoring group. By avoiding surgery and radiation, she was able to focus on other life challenges, such as caring for a teenage nephew and coping with the death of her husband. Clark’s DCIS remains stable with regular monitoring, offering hope to other women diagnosed with the condition.
Rethinking Lymph Node Removal in Early Breast Cancer
Another study, published in the Journal of the American Medical Association, examined the necessity of lymph node removal for women with early-stage breast cancer. Standard practice often involves a sentinel lymph node biopsy, where several lymph nodes in the armpit are removed to check for signs of cancer spread. However, this procedure can cause lasting complications, including arm swelling and pain.
The study, conducted in Germany, tracked 4,858 women who were randomly assigned to either undergo lymph node removal or avoid it during breast-conserving surgery. Five years later, the survival rates were nearly identical, with about 92% of women in both groups remaining alive and free of cancer. Researchers concluded that removing lymph nodes did not improve survival rates and that the risk of cancer recurrence in the armpit was low when lymph nodes were not removed.
While the findings offer a more cautious approach for many women, Dr. Morrow cautioned that some patients may still need lymph node removal to determine the best post-surgery treatment options, such as drug therapies.
These studies suggest that for some patients, less aggressive treatments could yield similar outcomes while reducing the physical and emotional toll of surgery. Researchers plan to continue following participants to assess long-term results, potentially reshaping the approach to breast cancer care.
