Points to Consider Regarding De-Escalation Surgery in High-Risk Breast Cancer

For women affected by breast cancer who carry germline BRCA1/2 pathogenic variants, the classic standard treatment consists of therapeutic unilateral mastectomy and risk-reducing contralateral mastectomy. However, data from recent literature demonstrate that for women treated with breast-conserving surgery who receive adequate adjuvant treatments, the increased risk of locoregional recurrences and a breast cancer-related prognosis is not significant. This review describes the clinical factors that could help clinicians decide either against or in favor of a more aggressive type of breast cancer surgery.