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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(01): 48-53
DOI: 10.1055/s-0043-124082
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Is Breast Surgery Necessary for Breast Carcinoma in Complete Remission Following Neoadjuvant Chemotherapy?

Article in several languages: English | deutsch
Hannah Richter
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
André Hennigs
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Benedikt Schaefgen
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Markus Hahn
2   Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
,
Jens Uwe Blohmer
3   Brustzentrum der Klinik für Gynäkologie, Campus Charité Mitte, Berlin, Germany
,
Sherko Kümmel
4   Brustzentrum der Kliniken Essen-Mitte, Evang. Huyssens-Stiftung/Knappschaft GmbH, Essen, Germany
,
Thorsten Kühn
5   Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen GmbH, Esslingen, Germany
,
Marc Thill
6   Brustzentrum, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
,
Kay Friedrichs
7   Mammazentrum am Krankenhaus Jerusalem Hamburg, Hamburg, Germany
,
Christof Sohn
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Michael Golatta
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
,
Jörg Heil
1   Brustzentrum der Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

received 22 September 2017
revised 02 December 2017

accepted 03 December 2017

Publication Date:
22 January 2018 (online)

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Abstract

The likelihood of pathological complete remission (pCR) of breast cancer following neoadjuvant chemotherapy (NACT) is increasing; most of all in the triple negative and HER2 positive tumour subgroups. The question thus arises whether or not breast surgery is necessary when there is complete remission after NACT, and whether it provides any improvement of the oncological treatment result when tumour is no longer detectable. Avoiding surgery and possibly even radiotherapy would only be conceivable on the basis of a reliable diagnosis of pCR without operating. Current imaging does not achieve the necessary sensitivity and specificity to assure the diagnosis of pathological complete remission. Further studies are therefore required to determine which methods are best able to evaluate tumour response to NACT. Studies on image-guided, minimally invasive biopsies after NACT have delivered first promising results towards diagnosing pCR before surgery and could provide the basis for further studies on the possibility of avoiding surgery in this specific patient collective.

Key words

neoadjuvant chemotherapy - minimally invasive biopsies - breast cancer - diagnosis - surgery
 

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