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Expert Explains State of Surgery in Nonmetastatic Breast Cancer

Caroline Seymour
Published: Monday, May 07, 2018

Maggie DiNome, MD

Maggie DiNome, MD
The approach and technique with surgery for nonmetastatic breast cancer have evolved since its advent as the primary method of treatment; however, Maggie DiNome, MD, said that although axillary dissection may become a thing of the past, surgery is still a key part of a multimodality treatment approach.

on Breast Cancer, DiNome, associate professor of surgery, of the University of California, Los Angeles Medical Center, discussed the evolution of surgical approaches in patients with early-stage breast cancer.

OncLive: Please provide an overview of your presentation.

DiNome: I spoke about the surgical management of early-stage breast cancer. One of the most fascinating things I find is that it has evolved significantly over the past century. We started off with surgery being the primary treatment for patients with breast cancer. Over the last several decades, we have learned that the biology of the cancer helps us determine the treatment approach. Now, surgery is only 1 part of a multimodality treatment strategy. We're doing good things, but we're learning that more surgery is not [necessarily] better surgery, and our treatment approach is paralleling that. 

Is the treatment approach to be more minimally invasive?

What we are understanding is that more surgery is not better. You don’t get a better survival outcome by doing a bigger surgery, and you also don’t get a worse survival outcome by doing a smaller surgery. Most of our patients are surviving breast cancer—certainly early-stage breast cancer. We're finding [the cancer] earlier, and we're treating it better. The systemic therapies given by our medical oncology colleagues are so much more effective, so people are living for long periods of time.
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