Rethinking Breast Cancer Treatment: Could Surgery Become Optional?

New Study Questions the Need for Surgery in Early-Stage Breast Cancer

Surgical removal has long been the standard treatment for breast cancer, but emerging research suggests that it might not be necessary for all patients. According to a recent study published in JAMA Oncology, up to 60% of early-stage breast cancer cases could be effectively treated without surgery when chemotherapy and radiation successfully eliminate the tumor.

The small-scale clinical trial, led by Dr. Henry Kuerer, a professor of breast surgical oncology at the University of Texas MD Anderson Cancer Center, tracked 31 women whose breast cancer had completely disappeared following non-surgical treatment. Five years after completing therapy, all remained alive and cancer-free, demonstrating the potential of this alternative approach.

“The absence of detectable recurrences at the five-year mark highlights the tremendous promise of this strategy,” Kuerer said. “Our innovative, precise method of detecting residual cancer has allowed us to identify patients who can safely avoid surgery.”

For decades, surgery has been the cornerstone of breast cancer treatment. However, with significant advancements in chemotherapy, more tumors are being eradicated before reaching the operating room. In fact, prior research indicates that pre-surgical (neoadjuvant) chemotherapy and radiation can completely eliminate tumors in up to 60% of patients, raising the question of whether surgery is still necessary in these cases.

To explore this possibility, researchers recruited 50 women over the age of 40 who had early-stage breast cancer. After completing chemotherapy, they underwent imaging and biopsy of the remaining breast tissue. Of these, 31 showed no residual cancer cells and were spared surgery. Instead, they continued with close monitoring and additional radiation therapy.

After an average follow-up of 4.5 years, none of the 31 patients experienced a recurrence of breast cancer, reinforcing the potential of this surgery-free approach.

“These promising results suggest that eliminating breast surgery for select invasive breast cancer cases could one day become the new standard of care,” Kuerer said. “For patients, this means the opportunity to preserve their bodies while still effectively treating their cancer.”

Encouraged by these findings, researchers have expanded the trial to include 100 patients and are collaborating with cancer specialists in South Korea to validate the results on a larger scale. However, experts caution that additional clinical trials are needed before this approach can be widely adopted.

“While we are optimistic about these outcomes, further research is essential before surgery-free treatment becomes a standard option,” Kuerer noted.

The study findings were also presented at the annual meeting of the Society of Surgical Oncology in Tampa, Florida, highlighting growing interest in evolving breast cancer treatment paradigms. If confirmed in larger trials, this research could mark a turning point in the way early-stage breast cancer is managed—offering a less invasive yet equally effective alternative for many patients.