Keynote Address at the ASBrS 2022 Annual Meeting Low-Risk Breast Cancer: When Is Local Therapy Enough?

Surgery, radiation, and chemotherapy have all been used to de-escalate the treatment of breast cancer patients. Despite its impact on local recurrence, systemic endocrine therapy (ET) has yet to be de-escalated, even though it has substantial adverse effects and a lower quality of life (QoL) over 5-10 years. The 21-gene recurrence score (RS) and MammaPrint have been used to identify subgroups of younger patients whose long-term survival is unaffected by adjuvant ET. Local treatment only, with de-escalation of long-term systemic ET for patients aged 50-69 with RS < 11, appears not to impact OS and should have an anticipated improvement in QoL.