2018
DOI: 10.1097/sla.0000000000002313
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A Clinical Feasibility Trial for Identification of Exceptional Responders in Whom Breast Cancer Surgery Can Be Eliminated Following Neoadjuvant Systemic Therapy

Abstract: After NST, image-guided FNA/VACB can accurately identify patients with a breast pCR. Based on these results, a prospective clinical trial has commenced in which breast surgery is omitted in patients with a breast pCR after NST according to image-guided biopsy.

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Cited by 156 publications
(132 citation statements)
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“…In line with recent reports the highest pCR rates in our series were achieved in Her2+ and TN tumors (59.5% and 29% respectively). In light of the impact of tumor subtype on the achievement of pCR, the need for breast surgery is being questioned in Her2+ and TN tumors, when a post NAC biopsy indicates a breast pCR, and clinical trials are currently ongoing, in which breast surgery is omitted in patients with these tumor subtypes and documented breast pCR . However, the optimal management of the axilla in this setting is still unknown.…”
Section: Discussionmentioning
confidence: 99%
“…In line with recent reports the highest pCR rates in our series were achieved in Her2+ and TN tumors (59.5% and 29% respectively). In light of the impact of tumor subtype on the achievement of pCR, the need for breast surgery is being questioned in Her2+ and TN tumors, when a post NAC biopsy indicates a breast pCR, and clinical trials are currently ongoing, in which breast surgery is omitted in patients with these tumor subtypes and documented breast pCR . However, the optimal management of the axilla in this setting is still unknown.…”
Section: Discussionmentioning
confidence: 99%
“…The predictive value of different imaging modalities has been evaluated among patients with a complete clinical response, but these methods are not sensitive enough to select patients for omission of surgery, as the negative predictive value for pCR is Nogi et al 9 28 stage II-III 18 Not defined EGFR-negative status (molecular marker) Huober et al 3 509 38.9 ypT0/Tis ypN0 Age < 40 years* Tumour grade, cT category, histological tumour type Masuda et al 8 13 . Kuerer and colleagues 14 have recently shown that it is possible to identify patients with a pCR in whom significant residual disease is unlikely by using improved imaging techniques, such as extensive image-guided vacuum-assisted core biopsy and fine-needle aspiration biopsy of the tumour bed. Similar prospective studies are being initiated internationally 15 -20 .…”
Section: Introductionmentioning
confidence: 99%
“…Kuerer et al performed a single‐center prospective trial of 40 patients with T1‐3N0‐3 triple‐negative or HER2+ cancers who had ultrasound‐guided or mammogram‐guided fine‐needle aspiration (FNA) and VACB of the primary tumor region after NAC before definitive surgical excision. The biopsy results were compared to the pathologic evaluation of the surgical specimen.…”
Section: Discussionmentioning
confidence: 99%