Surgery eliminated in highly selected patients with image-guided vacuum-assisted core biopsy-determined pathological complete response to neoadjuvant systemic therapy
THURSDAY, Oct. 27, 2022 (HealthDay News) — For highly selected patients with breast cancer, eliminating surgery may be feasible for neoadjuvant systemic therapy (NST) responders identified with an image-guided vacuum-assisted core biopsy (VACB), according to a study published online Oct. 25 in The Lancet Oncology.
Henry M. Kuerer, M.D., from The University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a multicenter phase 2 trial in seven centers in the United States involving women aged 40 years or older with unicentric cT1-2N0-1M0 triple-negative breast cancer or human epidermal growth factor receptor 2 (HER2)-positive breast cancer and a residual breast lesion less than 2 cm on imaging after clinically standard NST. Patients had one biopsy obtained by 9G image-guided VACB of the tumor bed; breast surgery was omitted if no invasive or in-situ disease was identified, and patients underwent standard whole-breast radiotherapy plus a boost.
Fifty patients underwent VACB following NST: 21 and 29 had triple-negative and HER2-positive breast cancer, respectively. The researchers found that VACB identified 31 patients (62 percent) with a pathological complete response. No ipsilateral recurrences occurred in these patients at a median follow-up of 26.4 months. There were no serious biopsy-related adverse events or deaths related to treatment reported.
“While these results are remarkable and quite promising, it’s important for patients to know this is the very beginning of a new type of treatment for select patients,” Kuerer said in a statement. “Much longer follow-up and further studies will be necessary before this approach can be integrated into routine breast cancer care.”
Several authors disclosed financial ties to the biopharmaceutical and publishing industries.
Editorial (subscription or payment may be required)
Copyright © 2022 HealthDay. All rights reserved.
