Multicenter phase 2 trial of selective elimination of breast surgery among patients with invasive breast cancer

The phase 2 Exceptional Responders Study, at 7 centers in the USA, included 50 women aged 40 years or older with cT1-2N0-1M0 HER2-positive or triple-negative breast cancer with exceptional response to neoadjuvant systemic therapy (NST) as determined by image-guided percutaneous biopsy. These patients were treated with radiotherapy alone without breast surgery. The ipsilateral breast tumor recurrence rate was 0% at a median follow-up of 55.4 months (IQR 44.0-63.5). The authors conclude that selective omission of breast surgery after NST may be feasible. More confirmatory studies are necessary before this new approach alters surgical practice.