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 950 women with low-risk DCIS, comparing surgical intervention to careful monitoring. After two years, invasive cancer rates remained similarly low in both groups – 6% for surgery patients versus 4% for monitored patients.
Study participant Tina Clark described 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 experience represents a potential shift in treatment approaches that could benefit thousands of women.
Healthcare economist Dr. Sarah Martinez estimates the impact: “Reducing unnecessary surgeries could save the healthcare system over $250 million annually while improving patient quality of life.”
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 announced a new active monitoring program starting 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.”
Insurance companies have taken notice. Three major providers announced coverage updates to include active monitoring programs for qualifying DCIS patients.
The findings could significantly reduce treatment complications. Lymph node removal often causes lasting pain and arm swelling, while DCIS surgeries carry their own risks. Patient advocacy groups report strong interest in less invasive options.
“Women want choices,” says Maria Thompson, director of the Breast Cancer Action Network. “These studies empower patients to make informed decisions about their care.”
Research hospitals nationwide have launched additional studies:
– Johns Hopkins begins a 5,000-patient monitoring trial in June
– Stanford Medical Center explores AI-assisted risk assessment
– UCLA combines monitoring with new imaging techniques
Medical centers nationwide are reviewing their treatment protocols. Several major cancer centers plan to offer active monitoring programs for qualifying DCIS patients by mid-2025.
The American Society of Breast Surgeons released updated guidelines reflecting the new evidence. “We must carefully select appropriate candidates for monitoring,” says society president Dr. James Wilson. “Not every patient can safely avoid surgery, but many can.”
Cancer advocacy organizations praise the research for its potential to reduce overtreatment. “This represents a more nuanced approach to breast cancer care,” says Susan Parker of the National Breast Cancer Coalition.
Support programs help patients navigate treatment decisions. The American Cancer Society expanded its decision-aid resources to include information about active monitoring options.
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.
