Breast Cancer Coverage from Every Angle

ASBrS 2019: Some Women With HER2-Positive Breast Cancer May Not Need Surgery

By: Sarah Campen, PharmD
Posted: Wednesday, May 8, 2019

Physicians may be able to determine which women with HER2-positive breast cancer do not require surgery after neoadjuvant chemotherapy based on several factors. They include tumor hormonal status, the presence of ductal carcinoma in situ (DCIS) at diagnosis, and imaging results. These were the findings of a study presented at the 2019 Annual Meeting of the American Society of Breast Surgeons (ASBrS) in Dallas.

“Evidence is growing that certain patients are exceptional [neoadjuvant chemotherapy] responders, suggesting that when properly identified someday certain of these women may be candidates for nonoperative treatment,” stated Susie Sun, MD, MS, of The University of Texas MD Anderson Cancer Center, Houston, in an ASBrS press release.

The study examined 280 patients with clinical T1–2 N0–1 HER2-positive breast cancer treated with neoadjuvant chemotherapy prior to surgical resection. Of these patients, 102 (36.4%) achieved pathologic complete response in the breast and lymph nodes after neoadjuvant systemic therapy.

Patients with residual disease in the breast and nodes were more likely to have hormone receptor–positive tumors (73.4%) compared with –negative tumors (50.8%; P < .0001). Incomplete radiologic response (P = .002) and hormone receptor–positive status (P < .0001) were also predictive of residual disease. Patients with DCIS (46.1%) were less likely to achieve pathologic complete response in the breast than patients without DCIS (31% vs. 43%; P = .038).

“This study and the clinical trial may help us delineate in the future which patients may be effectively treated nonoperatively, while allowing us to provide more aggressive surgical intervention to the women with HER2-positive breast cancer who need it,” concluded Dr. Sun.

Disclosure: For full disclosures of the study authors, visit

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