{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:56:31Z","timestamp":1791467791981,"version":"4.3.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Cancer Research and Development Fund","award":["2023-J-03"],"award-info":[{"award-number":["2023-J-03"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Breast cancer treatment is rapidly evolving toward precision-based de-escalation strategies for oncological safety and minimizing treatment-related morbidity. In early stage disease, minimally invasive approaches, such as non-surgical ablation techniques, including cryoablation and radiofrequency ablation, potentially constitute alternatives to conventional surgery for carefully selected low-risk tumors. Active surveillance trials challenge the necessity of immediate surgery for low-risk ductal carcinoma in situ, reflecting a paradigm shift toward risk-adapted management. In the neoadjuvant setting, achieving radiologic and pathologic complete responses, particularly in HER2-positive and triple-negative subtypes, is being investigated to determine the feasibility of omitting breast surgery under strict imaging and biopsy-guided protocols. Circulating tumor DNA-based minimal residual disease assays offer a promising tool for refining risk stratification and potentially guiding the extent of surgery and adjuvant therapy. These strategies represent a transformative movement toward biologically tailored, response-adapted, less invasive treatments for early breast cancer to optimize quality of life without compromising long-term outcomes.<\/jats:p>","DOI":"10.1093\/jjco\/hyag098","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:52:28Z","timestamp":1781092348000},"page":"1182-1188","source":"Crossref","is-referenced-by-count":1,"title":["De-escalation of breast surgery for early stage breast cancer"],"prefix":"10.1093","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0942-7599","authenticated-orcid":false,"given":"Takeshi","family":"Murata","sequence":"first","affiliation":[{"name":"Department of Breast Surgery, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomomi","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Breast 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Ariake, Koto-ku, Tokyo 135-8550 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Sakai","sequence":"additional","affiliation":[{"name":"Department of Breast Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research , 3-8-1, Ariake, Koto-ku, Tokyo 135-8550 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuaki","family":"Sagara","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgical Oncology, Sagara Hospital , 3-31 Matsubara-cho, Kagoshima-shi, Kagoshima 892-0833 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9393-9655","authenticated-orcid":false,"given":"Hideo","family":"Shigematsu","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University , 1-2-3 Kasumi, 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Endocrine Surgery, Akita University Hospital , 44-2 Hasunuma, Hirosawa, Akita-shi, Akita 010-8543 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8490-9064","authenticated-orcid":false,"given":"Yoichi","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, National Cancer Center Hospital East , 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba 277-8577 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Nozawa","sequence":"additional","affiliation":[{"name":"Department of Advanced Clinical Research and Development, Nagoya City University Graduate School of Medical Sciences , 1 Kawasumi, Mizuho-cho, Nagoya-shi, Aichi 467-8602 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