Q. Should We Treat All Breast Cancer Aggressively, Just to be Safe?

Q. Should we treat all breast cancer aggressively, just to be safe?

A. All patients don’t need all treatments. As our knowledge and understanding of outcomes has improved, we can safely personalize care. Using evidence-based management practices, we often are able to provide the best results with less treatment and minimal side effects.

Studies have shown that some patients over age 65 with early-stage breast cancer may be safely managed with surgery alone and may not need chemotherapy or radiation. In fact, radiation has not been shown to improve long-term survival in these patients

Similarly, chemotherapy is no longer prescribed for certain stages and types of breast cancer. We use molecular tests to determine which patients will and won’t benefit from chemotherapy.

For some patients when radiation is warranted, a single dose of intraoperative radiation can lower recurrence risk in a cost-effective way without causing side effects.

Because prognostic information based on molecular type allows us to personalize care, we engage patients in discussions of benefit and risk. They need to know that aggressive treatment may not always mean better outcomes.

Stephen Grobmyer, MD