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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Morrow M, Winer EP. De-escalating Breast Cancer Surgery—Where Is the Tipping Point? JAMA Oncol. 2020;6(2):183–184. doi:10.1001/jamaoncol.2019.4849
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