• Posted March 31, 2025

Surgery Not Necessary In Some Early-Stage Breast Cancers, Study Says

Surgery might not be needed to treat as many as 60% of early-stage breast cancers, a new study says.

Breast cancers that have been completely wiped out by chemotherapy and radiation treatment are not likely to come back, according to a small-scale clinical trial published March 28 in JAMA Oncology.

The trial tracked 31 women whose breast cancer had been eliminated with chemo and radiation, without surgery.

All of the women remained alive and cancer-free five years following treatment, results show.

"The absence of detectable breast cancer recurrences at the five-year mark highlights the tremendous potential of this surgery-free approach to breast cancer management," said lead investigator Dr. Henry Kuerer, a professor of breast surgical oncology at the University of Texas MD Anderson Cancer Center.

"Our innovative, precise method of detecting cancer in these patients has successfully demonstrated that we can treat them while avoiding surgery for this group,” Kuerer added in a news release.

This is the first clinical trial to test whether women can forego surgery if their breast cancers respond to chemotherapy, researchers said.

For more than a century, surgery has been the standard treatment for breast cancer, but advances in chemotherapy have significantly increased their effectiveness in wiping out these tumors, researchers said.

Previous studies have shown that chemotherapy and radiation delivered before surgery to shrink tumors winds up completely eliminating up to 60% of breast cancers, researchers said in background notes.

That raised the question of whether surgery is needed at all in these cases, they said.

For the study, researchers recruited 50 women over age 40 who had early-stage breast cancer. After undergoing standard chemotherapy, all the women had a residual breast lesion smaller than two centimeters where their tumor had been.

The women underwent needle biopsy to see if the lesion contained any cancer cells. No cancer was found in any of the 31 women, and they did not receive surgery.

Those women went on to remain cancer-free for an average of 4.5 years, results show.

"These continued promising results suggest that eliminating breast surgery for invasive breast cancer could become the new standard of care, offering women the opportunity to preserve their bodies,” Kuerer said.

The clinical trial has since been expanded to 100 patients, and also is being investigated by South Korean cancer doctors, researchers said.

“While we are hopeful that this approach will become routine, further clinical trials are necessary before this is a standard therapy,” Kuerer said.

The findings were also presented Thursday at a meeting of the Society of Surgical Oncology in Tampa, Fla.

More information

The Cleveland Clinic has more on chemotherapy delivered prior to breast cancer surgery.

SOURCES: MD Anderson Cancer Center, news release, March 28, 2025: JAMA Oncology, March 27, 2025