S13 Ep30: Biopsy-Guided Approach Enables Surgery Omission After pCR in HER2+ and Triple-Negative Breast Cancer: With Henry M. Kuerer, MD, PhD, FACS, CMQ

In today’s episode, we had the opportunity to speak with Henry M. Kuerer, MD, PhD, FACS, CMQ, about the potential to safely omit surgery in a subset of patients with early-stage HER2-positive or triple-negative breast cancer who achieve a pathologic complete response (pCR) following neoadjuvant systemic therapy. Dr Kuerer is a professor of breast surgical oncology at The University of Texas MD Anderson Cancer Center in Houston, Texas.In our conversation, Dr Kuerer reviewed the rationale behind a prospective phase 2 clinical trial (NCT02945579) testing image-guided vacuum-assisted core biopsy to identify patients with no residual disease after neoadjuvant therapy. He outlined the strict technical and eligibility criteria that enabled accurate detection of pCR—including tumors downsizing to less than 2 cm and biopsy of at least 12 cores from the tumor bed—and discussed why this biopsy-based approach may be more reliable than standard surgery in detecting residual disease. He also highlighted the broader clinical implications of the findings, noting that patients with biopsy-confirmed pCR may proceed directly to radiotherapy and avoid breast surgery altogether.