Studies Reveal Surgery-Free Options for Some Breast Cancer Patients

A recent study published in the New England Journal of Medicine reveals that some early breast cancer patients may safely forgo certain surgical procedures. This research, alongside another study in the Journal of the American Medical Association, addresses treatment options aimed at reducing the burden on patients.

The findings were presented at the San Antonio Breast Cancer Symposium. The first study particularly focuses on the necessity of lymph node removal in early breast cancer cases, while the second evaluates the approach to ductal carcinoma in situ (DCIS).

Each year, approximately 50,000 women in the United States are diagnosed with DCIS, a condition where cancerous cells form in the milk duct lining without affecting adjacent breast tissue. Traditionally, many choose surgery, but studies are now questioning the effectiveness of this approach in all cases, suggesting active monitoring as a viable alternative.

Based on data collected over two years, one study indicated that active monitoring could be as safe as surgery for many women diagnosed with low-risk DCIS. Dr. Virginia Kaklamani from the University of Texas Health Science Center noted, “This is an option that patients should consider for their DCIS.” However, she also acknowledged a need for additional long-term research to validate these results.

Dr. Monica Morrow of Memorial Sloan Kettering Cancer Center cautioned against overreliance on a two-year study for conclusive insights. The research involved over 950 women, with results showing no significant difference in invasive cancer rates between those who had surgery and those who were monitored actively.

Participants in the monitoring group underwent regular mammograms, with biopsies conducted if abnormalities were detected. Notably, participants could elect to undergo surgery at any point during the study. Separate analyses indicated that while some did not adhere strictly to their assigned treatment, the invasive cancer rates remained low.

Tina Clark, a participant diagnosed with DCIS in 2019, expressed gratitude for the study that allowed her to avoid surgery while managing personal challenges. At 63, she continues to schedule mammograms every six months to monitor her condition, providing a perspective on the importance of understanding one’s options.

The second study highlights the practice of sentinel lymph node biopsy during breast cancer surgeries. While this procedure checks for cancer spread, it can lead to lasting complications for patients. Research indicates that procedures might be safely omitted for certain patients, especially those with small tumors.

In a study conducted in Germany involving 4,858 women, researchers found no significant survival differences between those who underwent lymph node removal and those who did not after five years. Dr. Morrow emphasized that the risk of cancer recurrence in the armpit area remains low when lymph nodes are preserved.

Totality of evidence suggests a reevaluation of current surgical practices may benefit patients, leading to less invasive treatment options while still ensuring effective monitoring and care.