2024-SABCS-Takeaways - 8

SURGICAL ONCOLOGY SPOTLIGHT
Evidence continues to evolve when it comes
to informing treatment decisions in surgery
R
ight-sizing surgical
oncology has
brought successive
rounds of de-escalation
and can mean no surgery
at all. Discussion of
how to appropriately
right-size surgical
treatment of breast
cancer was a theme
throughout surgeryfocused
presentations
at the 2024 SABCS®.
Continue reading for key
surgical takeaways, and
remember registered
attendees can access
meeting presentations
and slides until
March 31, 2025.
Indeed, data presented
at the meeting showed
no significant difference
in oncologic outcomes
between active
surveillance and surgery
for patients with lowrisk
ductal carcinoma in
situ (DCIS) irrespective
of radiation therapy
(RT). Further, patients
readily accept active
surveillance that involves
mammograms every six
months. Patient-reported
outcomes also showed
similar results for active
surveillance compared to
surgery, with no evidence
of substantial negative
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impact of one
approach
over the
other at 24
months.
However,
surgical
oncology is
not about to
disappear.
A study presented
at the 2023 SABCS®
found that bilateral
mastectomy virtually
eliminated recurrence
for patients with BRCA1
mutation carriers. At 15
years, breast cancerspecific
survival was
virtually identical for
bilateral mastectomy
and breast-conserving
lumpectomy. A similar
analysis presented
this year suggested
that young women
have better survival
following risk-reducing
mastectomy compared
to no risk-reducing
mastectomy and even
better survival following
risk-reducing salpingooophorectomy
(RRSO).
8
Alastair Thompson,
MD, MBChB
" I would
plead for
someone
to pull
all these
data
together
and give
us that
balanced
look at what's the advice
we should give, " said
Alastair Thompson, MD,
MBChB, Professor and
Chief of the Section of
Breast Surgery, Baylor
College of Medicine.
New data from
Germany and Austria
support earlier studies
suggesting that
sentinel node surgery
may not be needed
for certain lower-risk
patients. Omitting
sentinel node surgery
is most appropriate
for postmenopausal
patients >50 years of
age with low-risk grade
1 or HR-positive, HER2negative
invasive breast
cancer with preoperative
tumors ≤2 cm.
2024 SABCS®
| Takeaways

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2024-SABCS-Takeaways

Table of Contents for the Digital Edition of 2024-SABCS-Takeaways