Future perspectives of surgical treatment of breast cancer

Ann Med Surg (Lond). 2020 Sep 16:59:93-95. doi: 10.1016/j.amsu.2020.09.021. eCollection 2020 Nov.

Abstract

Breast cancer is a heterogenous disease which requires updates on scientific research to offer patients the best possible and personalized treatment. Modern surgical treatment of breast cancer is recently been reviewed and it is clearly a field of continuous change and improvement. The change in treatment strategies is a challenge given that prognosis is already acceptable. The collaboration between specialties across different countries is needed to exchange experience and improve international guidelines. Multidisciplinary teams are mandatory for the patient to be provided with all treatment options and to make an informed decision on their treatment. The major trend in surgical treatment of breast cancer is de-escalating surgery and more focus on tumor biology. A "one-size-fits all" approach does not apply in treatment of breast cancer today. There are two major questions in future aspects of breast cancer treatment; Can surgery in the breast be omitted in patients with a pathological complete response after neoadjuvant therapy? And can some patients be spared axillary surgery? The timing of surgery is also debatable. These are major questions that need to be answered and through randomized controlled trials. This commentary gives an insight on thoughts and scientific research with focus on future aspects of breast cancer treatment.