Recent studies suggest that some patients diagnosed with early-stage breast cancer may safely avoid specific surgeries, offering them a less invasive treatment approach.
Research published in prominent medical journals points to potential benefits of active monitoring and more targeted interventions in specific cases, reducing the need for aggressive procedures.
One notable study, published in the New England Journal of Medicine, explores whether removing lymph nodes in early breast cancer is always necessary. The study suggests that in some cases, women may safely skip lymph node removal during breast cancer surgery, particularly for those with small tumors and early-stage cancers. The research followed nearly 5,000 women for five years, and found no significant difference in survival rates between those who had lymph nodes removed and those who did not. The findings challenge the conventional practice of routinely removing lymph nodes and could help patients avoid complications like arm swelling and pain.
Another study, featured in the Journal of the American Medical Association, focuses on ductal carcinoma in situ (DCIS), an early form of breast cancer where abnormal cells are confined to the milk ducts without spreading to surrounding tissue. Approximately 50,000 women in the U.S. are diagnosed with DCIS each year, often leading to surgery, radiation, and hormone therapy. However, this study suggests that for many women with low-risk DCIS, active monitoring might be an effective alternative to immediate surgery. In a two-year trial, women who were assigned to routine mammograms and monitoring had similar outcomes to those who underwent surgery, with a comparable incidence of invasive cancer development.
The trial involved nearly 1,000 women who were randomly assigned to either surgery or active monitoring. After two years, only a small percentage in both groups developed invasive breast cancer, and there were no significant differences in anxiety or quality of life between the two approaches. For some women, the ability to avoid surgery and radiation was a welcome relief, allowing them to focus on other aspects of their lives.
While the data is promising, experts caution that further long-term studies are needed to fully understand the safety and effectiveness of these less invasive approaches. The current studies have a follow-up period of only two years, and researchers plan to continue monitoring patients for at least five to ten years to ensure that cancer rates remain low. Some doctors, like Dr. Monica Morrow from Memorial Sloan Kettering Cancer Center, caution that more data is needed before these treatments can be widely recommended.
These studies align with a growing trend in cancer treatment where doctors are looking for ways to minimize the burden of treatments. Just as active surveillance is increasingly used in prostate cancer, researchers are exploring how to apply a similar strategy to certain forms of breast cancer. The idea is not to delay treatment indefinitely but to give patients more time to make informed decisions, without rushing into aggressive procedures.
For women with low-risk DCIS, or early-stage breast cancer, these findings may offer a new path forward, allowing for a more personalized approach to treatment. However, until further data is available, many doctors will continue to recommend surgery as the standard treatment option, particularly for women at higher risk of invasive disease.
The Associated Press, Time, and the Wall Street Journal contributed to this report.
