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Escalation or De-escalation?
Therapeutic escalation has also brought about significant problems.
• For patients: increasing burden of treatment-related toxicities, which can
cause important emotional, social and economic issues.
• Healthcare systems: enormous financial strain as treatment costs soar ever
higher.
Determining which patient will benefit from therapeutic escalation has proven to
be a scientific challenge.
Failure to de-escalate systemic treatments contrasts starkly with successful de-
escalation that come from breast cancer SURGERY and RADIOTHERAPY.