Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients?
Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Wong, Stephanie M. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2017 |
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| Schlagwörter: |
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| Anmerkung: |
© Springer Science+Business Media New York 2017 |
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| Übergeordnetes Werk: |
Enthalten in: Current breast cancer reports - Philadelphia, Pa. : Current Medicine Group LLC, 2009, 9(2017), 2 vom: 22. Apr., Seite 148-155 |
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| Übergeordnetes Werk: |
volume:9 ; year:2017 ; number:2 ; day:22 ; month:04 ; pages:148-155 |
| Links: |
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| DOI / URN: |
10.1007/s12609-017-0242-y |
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| Katalog-ID: |
SPR026341158 |
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| 520 | |a Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. | ||
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| 700 | 1 | |a De Los Santos, Jennifer |4 aut | |
| 700 | 1 | |a Basik, Mark |4 aut | |
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10.1007/s12609-017-0242-y doi (DE-627)SPR026341158 (SPR)s12609-017-0242-y-e DE-627 ger DE-627 rakwb eng Wong, Stephanie M. verfasserin aut Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media New York 2017 Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 De Los Santos, Jennifer aut Basik, Mark aut Enthalten in Current breast cancer reports Philadelphia, Pa. : Current Medicine Group LLC, 2009 9(2017), 2 vom: 22. Apr., Seite 148-155 (DE-627)59967461X (DE-600)2493862-2 1943-4596 nnns volume:9 year:2017 number:2 day:22 month:04 pages:148-155 https://dx.doi.org/10.1007/s12609-017-0242-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 9 2017 2 22 04 148-155 |
| spelling |
10.1007/s12609-017-0242-y doi (DE-627)SPR026341158 (SPR)s12609-017-0242-y-e DE-627 ger DE-627 rakwb eng Wong, Stephanie M. verfasserin aut Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media New York 2017 Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 De Los Santos, Jennifer aut Basik, Mark aut Enthalten in Current breast cancer reports Philadelphia, Pa. : Current Medicine Group LLC, 2009 9(2017), 2 vom: 22. Apr., Seite 148-155 (DE-627)59967461X (DE-600)2493862-2 1943-4596 nnns volume:9 year:2017 number:2 day:22 month:04 pages:148-155 https://dx.doi.org/10.1007/s12609-017-0242-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 9 2017 2 22 04 148-155 |
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10.1007/s12609-017-0242-y doi (DE-627)SPR026341158 (SPR)s12609-017-0242-y-e DE-627 ger DE-627 rakwb eng Wong, Stephanie M. verfasserin aut Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media New York 2017 Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 De Los Santos, Jennifer aut Basik, Mark aut Enthalten in Current breast cancer reports Philadelphia, Pa. : Current Medicine Group LLC, 2009 9(2017), 2 vom: 22. Apr., Seite 148-155 (DE-627)59967461X (DE-600)2493862-2 1943-4596 nnns volume:9 year:2017 number:2 day:22 month:04 pages:148-155 https://dx.doi.org/10.1007/s12609-017-0242-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 9 2017 2 22 04 148-155 |
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10.1007/s12609-017-0242-y doi (DE-627)SPR026341158 (SPR)s12609-017-0242-y-e DE-627 ger DE-627 rakwb eng Wong, Stephanie M. verfasserin aut Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media New York 2017 Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 De Los Santos, Jennifer aut Basik, Mark aut Enthalten in Current breast cancer reports Philadelphia, Pa. : Current Medicine Group LLC, 2009 9(2017), 2 vom: 22. Apr., Seite 148-155 (DE-627)59967461X (DE-600)2493862-2 1943-4596 nnns volume:9 year:2017 number:2 day:22 month:04 pages:148-155 https://dx.doi.org/10.1007/s12609-017-0242-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 9 2017 2 22 04 148-155 |
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10.1007/s12609-017-0242-y doi (DE-627)SPR026341158 (SPR)s12609-017-0242-y-e DE-627 ger DE-627 rakwb eng Wong, Stephanie M. verfasserin aut Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media New York 2017 Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 De Los Santos, Jennifer aut Basik, Mark aut Enthalten in Current breast cancer reports Philadelphia, Pa. : Current Medicine Group LLC, 2009 9(2017), 2 vom: 22. Apr., Seite 148-155 (DE-627)59967461X (DE-600)2493862-2 1943-4596 nnns volume:9 year:2017 number:2 day:22 month:04 pages:148-155 https://dx.doi.org/10.1007/s12609-017-0242-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 9 2017 2 22 04 148-155 |
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As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. 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Wong, Stephanie M. |
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Wong, Stephanie M. misc Breast neoplasms misc Cancer outcomes misc Neoadjuvant chemotherapy misc Surgery Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? |
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Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? Breast neoplasms (dpeaa)DE-He213 Cancer outcomes (dpeaa)DE-He213 Neoadjuvant chemotherapy (dpeaa)DE-He213 Surgery (dpeaa)DE-He213 |
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Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? |
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eliminating surgery in early-stage breast cancer: pipe-dream or worthy consideration in selected patients? |
| title_auth |
Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? |
| abstract |
Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. © Springer Science+Business Media New York 2017 |
| abstractGer |
Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. © Springer Science+Business Media New York 2017 |
| abstract_unstemmed |
Purpose of Review Neoadjuvant systemic therapy (NST) has become a valuable treatment approach for women with large operable and locally advanced breast cancers by lessening the extent of surgery required to adequately resect the primary tumour. As molecular subtyping has evolved, the development of highly efficient systemic and targeted therapies has resulted in a marked improvement in pathologic complete response (pCR) rates in specific breast cancer subtypes. As a result, breast surgeons are often performing surgery on the breasts that contain no tumour cells. Thus, the notion of de-escalating or avoiding surgery after neoadjuvant treatment has re-emerged. Recent Findings Retrospective series evaluating omission of surgery in women who demonstrate complete clinical response to NST suggest a trend towards increased rates of locoregional recurrence but predate the use of modern, targeted regimens. To be able to avoid surgery, it is critical to have the tools to accurately detect residual tumour disease and predict pCR after NST. Breast imaging including the recent addition of breast MRI has not sufficiently accurately predicted which patients will demonstrate pathologic complete response following NST. The combination of modern radiologic evaluation with image-guided tumour bed biopsies represents a potentially novel method towards selecting patients who could safely avoid surgical resection. Summary This article reviews the current evidence supporting the elimination of surgery in selected patients, and discusses ongoing and future trials that address the possibility of a non-operative approach in women with early-stage breast cancer. © Springer Science+Business Media New York 2017 |
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Eliminating Surgery in Early-Stage Breast Cancer: Pipe-Dream or Worthy Consideration in Selected Patients? |
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De Los Santos, Jennifer Basik, Mark |
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| score |
7.4008007 |