Breast Diseases; De-escalating Treatment: Current Status and Future Directions
A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".
Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 31784
Special Issue Editor
Special Issue Information
Dear Colleagues,
In recent years, attention has been directed to more personalized medicine in managing and treating breast lesions. A new concept has been introduced, “less is more”, meaning less treatment is better in some instances. This issue will focus on the areas in breast diseases that may benefit from fewer interventions. There are ongoing clinical trials examining active surveillance in managing low-risk DCIS. The majority of high-risk lesions such as lobular neoplasia, radial scars, papilloma, mucocele-like lesions, flat epithelial atypia, and fibroepithelial lesions with cellular stroma have low risks of progressing to more serious disease. Therefore, attention should be directed to the conservative management of such lesions. With the introduction of molecular assays for luminal-type breast cancers, many patients are spared unnecessary chemotherapies. The axillary region can be spared from unnecessary lymph node dissection based on the Z11 clinical trial. Some patients can avoid requiring a mastectomy by the separate excision of detected lesions. They are also ongoing trials to de-escalate surgical interventions in patients who achieve complete clinical responses after neoadjuvant chemotherapy. Extensive research has shown that tumor-infiltrating lymphocytes (TILs) play major roles in the response to chemotherapy in triple-negative breast cancer. Therefore, there is a call for de-escalating the chemotherapeutic regimen for patients with tumors high in TILs.
Prof. Dr. Thaer Khoury
Guest Editor
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Keywords
- breast cancer
- de-escalating
- active surveillance
- high-risk lesions
- luminal type
- triple-negative
- conservative surgery
- axillary lymph nodes
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