Groundbreaking research presented at the San Antonio Breast Cancer Symposium suggests thousands of women with early-stage breast cancer could safely avoid certain surgical procedures, potentially transforming standard treatment approaches and reducing unnecessary interventions.
Two major studies challenge long-standing practices. The first shows active monitoring might safely replace surgery for some patients with ductal carcinoma in situ (DCIS), a non-invasive breast condition affecting 50,000 U.S. women annually.
“This is an option that patients should consider for their DCIS,” says Dr. Virginia Kaklamani from the University of Texas Health Science Center San Antonio, who was not involved in the research. “We’ve historically taken an aggressive approach to DCIS, but these findings suggest we can be more selective.”
The study followed over 950 women with low-risk, hormone receptor-positive DCIS, comparing surgical intervention to careful monitoring. After two years, rates of invasive cancer were similarly low in both groups—approximately 10%.
Study participant Tina Clark described her experience avoiding surgery through monitoring: “I feel just so grateful and fortunate that I found this study when I did.” She now undergoes mammograms every six months. Her DCIS has not advanced, though a separate small cancer was detected and treated in her other breast in 2023. Her experience represents a potential shift in treatment approaches that could benefit thousands of women.
A separate German study involving 4,858 women found that skipping lymph node removal during early breast cancer surgery did not affect survival rates. After five years, about 92% of participants remained cancer-free, regardless of whether they had lymph nodes removed.
“Removing lymph nodes does not improve survival, and the risk of cancer recurrence in the armpit is quite low when lymph nodes are not removed,” says Dr. Monica Morrow from Memorial Sloan Kettering Cancer Center. “This challenges a decades-old standard practice.”
However, Dr. Morrow cautions that two years of DCIS monitoring may not provide enough data for definitive conclusions. Researchers plan to follow participants for at least a decade.
Major cancer centers are responding to the findings. Memorial Sloan Kettering Cancer Center announced a new active monitoring program starting in March 2025. MD Anderson Cancer Center plans similar changes by summer.
“We’re seeing a paradigm shift in breast cancer treatment,” says Dr. Rachel Chen, director of breast surgical oncology at Mayo Clinic. “These studies support what many of us have suspected – that we can safely de-escalate treatment in select cases.”
As research continues, medical centers emphasize the importance of individual assessment. “Each case requires careful evaluation,” Dr. Chen notes. “These findings add important options to our treatment toolkit.”
Patients interested in active monitoring should consult their healthcare providers about eligibility. The National Cancer Institute maintains a database of participating research centers.
