TY - JOUR
T1 - Omitting surgery for early breast cancer showing clinical complete response to primary systemic therapy
AU - Shigematsu, Hideo
AU - Fujisawa, Tomomi
AU - Shien, Tadahiko
AU - Iwata, Hiroji
N1 - Funding Information:
This report was supported in part by the National Cancer Center Research and Development Fund (29-A-3) from the Ministry of Health, Labour and Welfare and the Practical Research for Innovative Cancer Control (19ck0106307h0003) from Japan Agency for Medical Research and Development, AMED.
Publisher Copyright:
© 2020 The Author(s).
PY - 2020/5/7
Y1 - 2020/5/7
N2 - Breast cancer is highly sensitive to systemic therapy. High probability of pathological complete response suggests a clinical question that omitting surgery is an effective alternative to surgery in breast cancer showing clinical complete response to primary systemic therapy. However, the validity of omitting surgery for early breast cancer after primary systemic therapy has not been sufficiently established; thus, even if pathological complete response is expected in patients showing clinical complete response, excision of the primary tumor site remains the standard treatment of breast cancer. Inappropriate omitting surgery increases the incidence of local recurrence, which can be the risk of a subsequent distant metastasis and reduced overall survival. To achieve acceptable local control rate, omitting surgery should be investigated in patients with early breast cancer where a high percentage of pathological complete response, a high concordance rate between clinical complete response and pathological complete response and an acceptable local control rate are expected. This review presents concept and ongoing clinical trials for omitting surgery for patients with breast cancer showing clinical complete response to primary systemic therapy.
AB - Breast cancer is highly sensitive to systemic therapy. High probability of pathological complete response suggests a clinical question that omitting surgery is an effective alternative to surgery in breast cancer showing clinical complete response to primary systemic therapy. However, the validity of omitting surgery for early breast cancer after primary systemic therapy has not been sufficiently established; thus, even if pathological complete response is expected in patients showing clinical complete response, excision of the primary tumor site remains the standard treatment of breast cancer. Inappropriate omitting surgery increases the incidence of local recurrence, which can be the risk of a subsequent distant metastasis and reduced overall survival. To achieve acceptable local control rate, omitting surgery should be investigated in patients with early breast cancer where a high percentage of pathological complete response, a high concordance rate between clinical complete response and pathological complete response and an acceptable local control rate are expected. This review presents concept and ongoing clinical trials for omitting surgery for patients with breast cancer showing clinical complete response to primary systemic therapy.
KW - breast cancer
KW - clinical complete response
KW - omitting surgery
KW - pathological complete response
KW - primary systemic therapy
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U2 - 10.1093/jjco/hyaa055
DO - 10.1093/jjco/hyaa055
M3 - Review article
C2 - 32378709
AN - SCOPUS:85086346266
VL - 50
SP - 629
EP - 634
JO - Japanese Journal of Clinical Oncology
JF - Japanese Journal of Clinical Oncology
SN - 0368-2811
IS - 6
ER -
