Modern neoadjuvant systemic therapy (NST) can result in high pathologic complete response rates (pCR) in triple negative (TN) and human epidermal growth factor receptor 2 positive (HER2+) breast cancer. The role of surgery is, therefore, being reconsidered in this rapidly evolving field. This report presents oncological outcomes of seven patients with TN or HER2+ breast cancer, with exceptional response to NST, and a post-NST image-guided vacuum assisted biopsy showing no residual disease (ypT0), who opted not to have breast surgery. The median age was 49 (IQR 36–61) years and the median tumour size at diagnosis was 50 (IQR 16–65) mm. All patients received breast radiotherapy and continued adjuvant systemic therapies as appropriate. At a median follow-up of 67 (IQR 61–77) months, all patients were alive and free of disease. This small case series supports the need for further research in ‘exceptional responders’ to provide safe, individualized patient-centred care.

中文翻译：

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对新辅助全身治疗反应良好的选定乳腺癌患者省略乳房手术

现代新辅助全身治疗 (NST) 可在三阴性 (TN) 和人表皮生长因子受体 2 阳性 (HER2+) 乳腺癌中带来较高的病理完全缓解率 (pCR)。因此，在这个快速发展的领域，人们正在重新考虑手术的作用。本报告介绍了 7 名 TN 或 HER2+ 乳腺癌患者的肿瘤学结果，他们对 NST 反应异常，且 NST 后图像引导真空辅助活检显示无残留疾病 (ypT0)，但他们选择不进行乳房手术。中位年龄为 49 (IQR 36-61) 岁，诊断时肿瘤大小中位为 50 (IQR 16-65) mm。所有患者均接受乳腺放射治疗并酌情继续辅助全身治疗。中位随访时间为 67 (IQR 61-77) 个月，所有患者均存活且无疾病。这个小病例系列支持对“特殊反应者”进行进一步研究的需要，以提供安全、以患者为中心的个性化护理。