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December 12, 2019

De-escalating Breast Cancer Surgery—Where Is the Tipping Point?

Author Affiliations
  • 1Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
  • 2Department of Medical Oncology, Dana-Farber Cancer Center, Harvard Medical School, Boston, Massachusetts
JAMA Oncol. 2020;6(2):183-184. doi:10.1001/jamaoncol.2019.4849

Breast cancer survival in the United States has improved because of the increased uptake of screening mammography and improvements in systemic therapy. The cancers clinicians see today are smaller and have less nodal involvement than those seen in the 1990s, when many of the current treatment paradigms were developed. It is now recognized that subtype-specific systemic therapies reduce the incidence of locoregional as well as distant recurrences, and the neoadjuvant chemotherapy (NAC) paradigm has demonstrated that pathologic complete response, a powerful marker of favorable outcomes, can often be obtained in patients with human epidermal growth factor receptor 2 gene (HER2) overexpression and triple-negative cancers.

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