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Breast Cancer Clinical Trials: Past Half Century Moving Forward Advancing Patient Outcomes

Henry M Kuerer1, Raquel F D van la Parra2,3

  • 1Division of Surgery, Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. hkuerer@mdanderson.org.

Annals of Surgical Oncology
|July 2, 2016
PubMed

Insights

Clinical trials are refining breast cancer treatment, reducing surgery's extent for ductal carcinoma in situ (DCIS) and node-positive disease through targeted therapies and active surveillance, potentially preventing overtreatment.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Clinical Trials

Background:

  • Advancements in breast cancer screening and systemic therapies are reducing the need for extensive surgery.
  • Clinical trials have significantly improved multimodal breast cancer treatment strategies.
  • Current research focuses on minimizing surgical intervention while maintaining disease control.

Purpose of the Study:

  • To review landmark clinical trials impacting breast cancer management.
  • To update on the evolving role of surgery in DCIS and node-positive breast cancer.
  • To discuss the integration of systemic and local therapies, including nonoperative approaches.

Main Methods:

  • Review of sequential clinical trials for ductal carcinoma in situ (DCIS).
  • Analysis of trials investigating axillary surgery extent in node-positive disease post-neoadjuvant chemotherapy.
  • Examination of feasibility studies for nonoperative therapy in invasive breast cancer.

Main Results:

  • Improved screening and systemic therapies are decreasing surgical extent.
  • Active surveillance trials for DCIS aim to prevent overtreatment of low-grade disease.
  • Selective node dissection and nonoperative therapy are emerging options based on treatment response.

Conclusions:

  • Clinical trials are driving a paradigm shift towards less invasive breast cancer treatments.
  • The management of DCIS is evolving towards active surveillance for select cases.
  • Integration of systemic therapy allows for tailored local treatment, including potential nonoperative management.

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