De-Escalating the Management of In Situ and Invasive Breast Cancer

Fernando A. Angarita, Robert Brumer, Matthew Castelo, Nestor F. Esnaola, Stephen B. Edge, Kazuaki Takabe

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


It is necessary to identify appropriate areas of de-escalation in breast cancer treatment to minimize morbidity and maximize patients’ quality of life. Less radical treatment modalities, or even no treatment, have been reconsidered if they offer the same oncologic outcomes as standard therapies. Identifying which patients benefit from de-escalation requires particular care, as standard therapies will continue to offer adequate cancer outcomes. We provide an overview of the literature on the de-escalation of treatment of ductal carcinoma in situ (DCIS), local treatment of breast cancer, and surgery after neoadjuvant systemic therapy. De-escalation of breast cancer treatment is a key area of investigation that will continue to remain a priority. Improvements in understanding the natural history and biology of breast cancer, imaging modalities, and adjuvant treatments will expand this even further. Future efforts will continue to challenge us to consider the true role of various treatment modalities.

Original languageEnglish (US)
Article number4545
Issue number19
StatePublished - Sep 20 2022


  • breast cancer
  • breast surgery
  • de-escalation
  • ductal carcinoma in situ
  • neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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