TY - JOUR
T1 - De-escalation towards omission is the tipping point of individualizing breast cancer surgery
AU - Heil, Joerg
AU - Pfob, André
AU - Kuerer, Henry Mark
N1 - Publisher Copyright:
© 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2020/8
Y1 - 2020/8
N2 - Tailoring of breast cancer treatment to the individual has especially occurred in breast cancer surgery: paradigms have changed from Halsted's radical mastectomy in 1882, to simple mastectomy, to lumpectomy. Within the next decade, we might face another paradigm change of omitting breast cancer surgery at all in case of a complete response after neoadjuvant systemic treatment. In this article, we provide an overview of the reasoning for this new paradigm change, the criticism it has evoked, and under which conditions it might be incorporated into clinical practice. We also take a look at previous paradigm changes in breast cancer surgery and the insights they provide us in the current situation on a statistical but also on a psychological level.
AB - Tailoring of breast cancer treatment to the individual has especially occurred in breast cancer surgery: paradigms have changed from Halsted's radical mastectomy in 1882, to simple mastectomy, to lumpectomy. Within the next decade, we might face another paradigm change of omitting breast cancer surgery at all in case of a complete response after neoadjuvant systemic treatment. In this article, we provide an overview of the reasoning for this new paradigm change, the criticism it has evoked, and under which conditions it might be incorporated into clinical practice. We also take a look at previous paradigm changes in breast cancer surgery and the insights they provide us in the current situation on a statistical but also on a psychological level.
KW - Individualized treatment
KW - Neoadjuvant systemic treatment
KW - Omission of breast cancer surgery
KW - Pathologic complete response
KW - Vacuum-assisted biopsy
UR - http://www.scopus.com/inward/record.url?scp=85082835258&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082835258&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2020.03.208
DO - 10.1016/j.ejso.2020.03.208
M3 - Article
C2 - 32241595
AN - SCOPUS:85082835258
SN - 0748-7983
VL - 46
SP - 1543
EP - 1545
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 8
ER -