{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:37:42Z","timestamp":1782513462671,"version":"3.54.5"},"reference-count":98,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"US National Institutes of Health (NIH)","award":["R37CA248018"],"award-info":[{"award-number":["R37CA248018"]}]},{"name":"US National Institutes of Health (NIH)","award":["R01CA250412"],"award-info":[{"award-number":["R01CA250412"]}]},{"name":"US National Institutes of Health (NIH)","award":["R01CA251545"],"award-info":[{"award-number":["R01CA251545"]}]},{"name":"US National Institutes of Health (NIH)","award":["R01EB029596"],"award-info":[{"award-number":["R01EB029596"]}]},{"name":"US National Institutes of Health (NIH)","award":["W81XWH-19\u20131-0674"],"award-info":[{"award-number":["W81XWH-19\u20131-0674"]}]},{"name":"US National Institutes of Health (NIH)","award":["W81XWH-19\u20131-0111"],"award-info":[{"award-number":["W81XWH-19\u20131-0111"]}]},{"name":"US National Institutes of Health (NIH)","award":["P30CA016056"],"award-info":[{"award-number":["P30CA016056"]}]},{"name":"US Department of Defense BCRP","award":["R37CA248018"],"award-info":[{"award-number":["R37CA248018"]}]},{"name":"US Department of Defense BCRP","award":["R01CA250412"],"award-info":[{"award-number":["R01CA250412"]}]},{"name":"US Department of Defense BCRP","award":["R01CA251545"],"award-info":[{"award-number":["R01CA251545"]}]},{"name":"US Department of Defense BCRP","award":["R01EB029596"],"award-info":[{"award-number":["R01EB029596"]}]},{"name":"US Department of Defense BCRP","award":["W81XWH-19\u20131-0674"],"award-info":[{"award-number":["W81XWH-19\u20131-0674"]}]},{"name":"US Department of Defense BCRP","award":["W81XWH-19\u20131-0111"],"award-info":[{"award-number":["W81XWH-19\u20131-0111"]}]},{"name":"US Department of Defense BCRP","award":["P30CA016056"],"award-info":[{"award-number":["P30CA016056"]}]},{"name":"National Cancer Institute cancer center","award":["R37CA248018"],"award-info":[{"award-number":["R37CA248018"]}]},{"name":"National Cancer Institute cancer center","award":["R01CA250412"],"award-info":[{"award-number":["R01CA250412"]}]},{"name":"National Cancer Institute cancer center","award":["R01CA251545"],"award-info":[{"award-number":["R01CA251545"]}]},{"name":"National Cancer Institute cancer center","award":["R01EB029596"],"award-info":[{"award-number":["R01EB029596"]}]},{"name":"National Cancer Institute cancer center","award":["W81XWH-19\u20131-0674"],"award-info":[{"award-number":["W81XWH-19\u20131-0674"]}]},{"name":"National Cancer Institute cancer center","award":["W81XWH-19\u20131-0111"],"award-info":[{"award-number":["W81XWH-19\u20131-0111"]}]},{"name":"National Cancer Institute cancer center","award":["P30CA016056"],"award-info":[{"award-number":["P30CA016056"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>It is necessary to identify appropriate areas of de-escalation in breast cancer treatment to minimize morbidity and maximize patients\u2019 quality of life. Less radical treatment modalities, or even no treatment, have been reconsidered if they offer the same oncologic outcomes as standard therapies. Identifying which patients benefit from de-escalation requires particular care, as standard therapies will continue to offer adequate cancer outcomes. We provide an overview of the literature on the de-escalation of treatment of ductal carcinoma in situ (DCIS), local treatment of breast cancer, and surgery after neoadjuvant systemic therapy. De-escalation of breast cancer treatment is a key area of investigation that will continue to remain a priority. Improvements in understanding the natural history and biology of breast cancer, imaging modalities, and adjuvant treatments will expand this even further. Future efforts will continue to challenge us to consider the true role of various treatment modalities.<\/jats:p>","DOI":"10.3390\/cancers14194545","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T21:12:53Z","timestamp":1663708373000},"page":"4545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["De-Escalating the Management of In Situ and Invasive Breast Cancer"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8546-7309","authenticated-orcid":false,"given":"Fernando A.","family":"Angarita","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Brumer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7477-7400","authenticated-orcid":false,"given":"Matthew","family":"Castelo","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON M5T 2S8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestor F.","family":"Esnaola","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology and Gastrointestinal Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Edge","sequence":"additional","affiliation":[{"name":"Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"},{"name":"Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 12246, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6435-4241","authenticated-orcid":false,"given":"Kazuaki","family":"Takabe","sequence":"additional","affiliation":[{"name":"Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"},{"name":"Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 12246, USA"},{"name":"Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan"},{"name":"Department of Breast Surgery, Fukushima Medical University, Fukushima 960-1295, Japan"},{"name":"Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J. 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