Some women with triple negative early stage breast cancer may be able to safely forgo surgery

Chemotherapy and radiation may be all that's need for certain types of early stage breast cancer – Photo credit Unsplash/COO public domain

CANCER DIGEST – March 29, 2025 – In the first modern clinical trial treating patients with early-stage breast cancer who had a complete response to chemotherapy and radiation without surgery, 100 percent of patients were surviving cancer free after a little more than 4.5 years.

The study, published in the March 28, 2025 JAMA Oncology, and presented the same day at the Society of Surgical Oncology 2025 Annual Meeting in Tampa, Fl, suggests that some patients may be able to avoid breast surgery, which has long been part of standard treatment.

"The absence of detectable breast cancer recurrences at the five-year mark highlights the tremendous potential of this surgery-free approach to breast cancer management," Henry Kuerer, M.D., Ph.D. said in a press release. The trial’s principal investigator is professor of Breast Surgical Oncology. "Our innovative, precise method of detecting cancer in these patients has successfully demonstrated that we can treat them while avoiding surgery for this group."

The multi-center trail involved 50 women with an average age of 62, diagnosed with early stage breast cancer, meaning it had not spread beyond breast tissue. Of the  50 women, 21 had triple negative breast cancer, meaning the tumor had no estrogen and the tissue did not have receptors for progesterone or HER-2, called HER-2 negative. Such tumors are aggressive and cannot be treated immunotherapies that target these receptors. Another 29 patients were negative for estrogen and progesterone, but were HER-2 positive.

All patients had lesions of less the 2cm (3/4 inch) after chemotherapy as seen on imaging, and underwent image-guided biopsies examined by pathologists. Thirty-one (31) of the biopsy samples showed no signs of remaining cancer and those women were then treated with radiation but no surgery. All of those women were surviving cancer-free after nearly 5 years.

The trial is now expanding to more cancer centers including some in South Korea to enroll more women and to further test the results of the protocol. If the findings continue to show similar results as this early trial, it could change standard of care for women with this type of early stage breast cancer, eliminating the need for surgery for many women.

Source: MD Anderson Cancer press release via Medical Xpress