Breast Surgery Research and Clinical Trials

Surgeons within the Division of Breast Surgery provide daily care to patients while also devoting their time and expertise to research. As active physician-scientists, our surgeons move discoveries from concept to research to direct patient care—pioneering life-changing approaches that improve diagnoses, treatment techniques and quality of life.

Our surgeons are investigating breast disease on multiple fronts, including:

• Personalizing prevention strategies
• Patient satisfaction and quality of life
• Optimizing multidisciplinary treatment planning, including surgery, systemic therapy and radiation
• Less invasive surgical techniques
• Breast cancer in young women
• Advanced imaging modalities to reduce the need for multiple surgeries [Advanced Multimodality Image Guided Operating (AMIGO)] Suite
• Improved understanding of the environment around the breast tumor, including blood vessels, immune cells and other biological components (referred to as the tumor microenvironment)

Breast Surgery Research Projects

• Analyzing patient-reported outcomes in breast cancer surgery.
• Studying management of the axilla after preoperative systemic chemotherapy with particular focus on individual tumor features.
• Using artificial intelligence to predict the likelihood of cancer in women with a biopsy of atypical ductal hyperplasia (ADH).
• Individualizing treatment options for women with non-invasive disease including ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS).
• Examining surgical techniques and advanced imaging modalities to optimize surgical treatments and outcomes.
• Studying the tumor microenvironment to better understand the immune response to breast cancer.

If appropriate, your surgeon will discuss opportunities for you to participate in one of our current research studies.

Breast Surgery Clinical Trials

• Phase II study evaluating mass spectrometry and intraoperative MRI (iMRI) in the Advanced Multimodality Image-Guided Operating suite (AMIGO) in breast-conserving surgery. Phase I results showed that tumor assessment is enhanced by iMRI with the patient lying facing upward rather than downward. Learn more about this clinical trial. Read this related article.
• Comparison of Operative to Monitoring and Endocrine Therapy (COMET) Trial is a phase III randomized trial investigating the benefits for active surveillance compared with standard care for patients with low risk ductal carcinoma in situ (DCIS). Learn more about this clinical trial.

These are just a few breast cancer trials that may be available to you. Visit the clinical trials page to access a complete list of all breast cancer clinical trials open to new participants. Your surgeon will discuss these opportunities with you further.

Selection of Recently Published Projects

Prevention and Early Disease

• Laws A, Katlin F, Hans M, Graichen M, Kantor O, Minami C, Bychkovsky BL, Pace LE, Scheib R, Garber JE, King TA. Screening MRI Does Not Increase Cancer Detection or Result in an Earlier Stage at Diagnosis for Patients with High-Risk Breast Lesions: A Propensity Score Analysis. Ann Surg Oncol. 2022.
• Bychkovsky B, Laws A, Katlin F, Hans M, Knust Graichen M, Pace LE, Scheib R, Garber JE, King TA. Initiation and tolerance of chemoprevention among women with high-risk breast lesions: the potential of low-dose tamoxifen. Breast Cancer Res Treat. 2022.
• Laws A, Katlin F, Nakhlis F, Chikarmane SA, Schnitt SJ, King TA. Atypical Lobular Hyperplasia and Classic Lobular Carcinoma In Situ Can Be Safely Managed Without Surgical Excision. Ann Surg Oncol. 2022.
• Nakhlis F, Baker GM, Pilewskie M, Gelman R, Calvillo KZ, Ludwig K, McAuliffe PF, Willey S, Rosenberger LH, Parker C, Gallagher K, Jacobs L, Feldman S, Lange P, DeSantis SD, Schnitt SJ, King TA. The Incidence of Adjacent Synchronous Invasive Carcinoma and/or Ductal Carcinoma In Situ in Patients with Intraductal Papilloma without Atypia on Core Biopsy: Results from a Prospective Multi-Institutional Registry (TBCRC 034). Ann Surg Oncol. 2021.

Patient Centered Outcomes and Disparities

• Dominici L, Hu J, Zheng Y, Kim HJ, King TA, Ruddy KJ, Tamimi RM, Peppercorn J, Schapira L, Borges VF, Come SE, Warner E, Wong JS, Partridge AH, Rosenberg SM. Association of Local Therapy With Quality-of-Life Outcomes in Young Women With Breast Cancer. JAMA Surg. 2021.
• Kuijer A, Dominici LS, Rosenberg SM, Hu J, Gelber S, Di Lascio S, Wong JS, Ruddy KJ, Tamimi RM, Schapira L, Borges VF, Come SE, Sprunck-Harrild K, Partridge AH, King TA. Arm Morbidity After Local Therapy for Young Breast Cancer Patients. Ann Surg Oncol. 2021.
• Minami CA, Freedman RA, Karamourtopoulos M, Pinheiro A, Gilliam E, Aliberti G, Pories SE, Recht A, Lotz M, Dominici LS, Schonberg MA. Acceptability of a patient decision aid for women aged 70 and older with stage I, estrogen receptor-positive, HER2-negative breast cancer. J Geriatr Oncol. 2021.
• Kantor O, Wang ML, Bertrand K, Pierce L, Freedman RA, Chavez-MacGregor M, King TA, Mittendorf EA. Racial and Socioeconomic Disparities in Breast Cancer Outcomes within the AJCC Pathologic Prognostic Staging System. Ann Surg Oncol. 2022.

Tailored Local Therapy

• Minami CA, Jin G, Schonberg MA, Freedman RA, King TA, Mittendorf EA. Variation in Deescalated Axillary Surgical Practices in Older Women with Early-Stage Breast Cancer. Ann Surg Oncol. 2022.
• Mittendorf EA, Kantor O, Weiss A, Richardson E, Garrido-Castro A, Portnow LH, Krop IE, Lin NU, Winer EP, Tolaney SM, King TA. Nodal Positivity in Early-Stage Triple-Negative Breast Cancer: Implications for Preoperative Immunotherapy. Ann Surg Oncol. 2022.
• Kantor O, Means J, Grossmith S, Dey T, Bellon JR, Mittendorf EA, King TA. Optimizing Axillary Management in Clinical T1-2N0 Mastectomy Patients with Positive Sentinel Lymph Nodes. Ann Surg Oncol. 2022.
• Weiss A, King C, Vincuilla J, Parker T, Portnow L, Nakhlis F, Dominici L, Mittendorf EA, King TA. Rates of pathologic nodal disease among cN0 and cN1 patients undergoing routine axillary ultrasound and neoadjuvant chemotherapy. Breast Cancer Res Treat. 2022.

Tumor Immunology

• Yam C, Yen EY, Chang JT, Bassett RL, Alatrash G, Garber H, Huo L, Yang F, Philips AV, Ding QQ, Lim B, Ueno NT, Kannan K, Sun X, Sun B, Parra Cuentas ER, Symmans WF, White JB, Ravenberg E, Seth S, Guerriero JL, Rauch GM, Damodaran S, Litton JK, Wargo JA, Hortobagyi GN, Futreal A, Wistuba II, Sun R, Moulder SL, Mittendorf EA. Immune Phenotype and Response to Neoadjuvant Therapy in Triple-Negative Breast Cancer. Clin Cancer Res. 2021.

Quality Improvement Initiatives

• Lyu HG, Kantor O, Laws AD, McDonald J, Pham L, Dominici LS, Vincuilla J, Raut CP, Danilchuk B, Novak L, Parker T, King TA, Mittendorf EA. Development of an Electronic Health Record Registry to Facilitate Collection of Commission on Cancer Metrics for Patients Undergoing Surgery for Breast Cancer. JCO Clin Cancer Inform. 2022.
• Kantor O, King TA, Shak S, Russell CA, Giuliano AE, Hortobagyi GN, Burstein HJ, Winer EP, Dey T, Sparano JA, Mittendorf EA. Expanding Criteria for Prognostic Stage IA in Hormone Receptor-Positive Breast Cancer. J Natl Cancer Inst. 2021.

Support Our Breast Surgery Research

Your contributions to our research will provide even better care for the next generation of patients and their families. Your contributions can be directed in many ways, such as:

• Tailoring therapy based on tumor type
• Improving surgical processes, techniques and protocols
• Improving the patient experience and optimizing quality of life after breast cancer treatment
• Developing new prevention strategies for women at increased risk
• In depth analysis of the tumor and surrounding immune cells to identify ways to mobilize a patient’s own immune system to fight their cancer

Learn how you can support our breast surgery research projects.