A new study has found that active monitoring is noninferior to guideline-concordant care for patients with ductal carcinoma in situ (DCIS). The study, presented at the annual San Antonio Breast Cancer Symposium, involved 995 participants with low-risk DCIS who were randomly assigned to either guideline-concordant care or active monitoring.
Guideline-concordant care typically involves surgery followed by adjuvant radiation. In contrast, active monitoring allows patients to undergo surgical intervention only upon invasive progression diagnosis, or they can choose to have surgery at any time. Patients in both groups were allowed to receive endocrine therapy if desired.
The two-year cumulative rate of invasive ipsilateral breast cancer was 5.9% for the guideline-concordant care group and 4.2% for the active monitoring group, meeting the threshold for noninferiority. More patients in the active monitoring arm received endocrine therapy, with 71.3% versus 65.5% in the guideline-concordant care arm.
The study’s lead author, Dr. E. Shelley Hwang, stated that the findings are reassuring and have important implications for future treatment options. The omission of surgery has been highly controversial, but the results suggest that active monitoring is a viable alternative to traditional treatment approaches.
Source: https://www.endocrinologyadvisor.com/news/sabcs-active-monitoring-noninferior-to-guideline-care-for-ductal-carcinoma-in-situ