PATIENTS with low-risk ductal carcinoma in situ (DCIS) who chose active monitoring over immediate surgery reported similar quality-of-life outcomes, according to findings from the COMET trial presented at the 2024 San Antonio Breast Cancer Symposium (SABCS).
The study, involving 995 patients with grade 1 or 2, hormone receptor-positive, HER2-negative DCIS, explored whether active monitoring, a strategy of close observation with surgery only if invasive cancer develops, could match standard surgical care in preserving physical and mental health.
Researchers measured outcomes using validated surveys to assess health-related quality of life, anxiety, depression, and breast cancer-related symptoms. Findings over 2 years showed no significant differences in overall health-related quality of life, anxiety, or worry about DCIS between the groups. Depression scores were slightly higher in the surgical group, though the difference was not statistically significant.
However, patients undergoing surgery reported transiently lower physical functioning scores and a greater burden of arm problems, breast pain, and sensory disturbances. These issues typically resolved by 2 years.
“The data suggest that, in the short term, active monitoring is a reasonable approach in terms of patient experience,” said lead researcher Ann Partridge, of the Dana-Farber Cancer Institute.
Limitations of the study include its short follow-up period and limited racial and age diversity. Still, these findings highlight the potential for active monitoring as a viable management strategy for women with low-risk DCIS, pending longer-term data.
This study adds to the growing conversation around treatment de-escalation in low-risk breast cancer cases, emphasizing patient-centered care and informed decision-making.
Reference: San Antonio Breast Cancer Symposium. (2024, December 12). COMET Trial Finds Quality of Life Similar Among Patients with Low-risk DCIS Whether They Received Active Monitoring or Surgery. Presented at SABCS 2024.
Anaya Malik | AMJ
