Pathologic complete response of ductal carcinoma in situ to neoadjuvant systemic therapy in HER2-positive invasive breast cancer patients: a nationwide analysis.

Autor: Ploumen RAW; Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands. r.ploumen@maastrichtuniversity.nl.; GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands. r.ploumen@maastrichtuniversity.nl., Claassens EL; Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands., Kooreman LFS; GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands.; Department of Pathology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Keymeulen KBMI; Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands., van Kats MACE; Department of Medical Oncology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Gommers S; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands., Siesling S; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands., van Nijnatten TJA; GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands.; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands., Smidt ML; Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands.; GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2023 Sep; Vol. 201 (2), pp. 227-235. Date of Electronic Publication: 2023 Jul 03.
DOI: 10.1007/s10549-023-07012-z
Abstrakt: Purpose: Ductal carcinoma in situ (DCIS) is present in more than half of HER2-positive invasive breast cancer (IBC). Recent studies show that DCIS accompanying HER2-positive IBC can be completely eradicated by neoadjuvant systemic therapy (NST). Our aim was to determine the percentage of pathologic complete response of the DCIS component in a nationwide cohort and to assess associated clinicopathologic variables. Furthermore, the impact on surgical treatment after NST was investigated.
Methods: Women diagnosed with HER2-positive IBC, treated with NST and surgery, between 2010 and 2020, were selected from the Netherlands Cancer Registry. Pre-NST biopsy and postoperative pathology reports were obtained from the Dutch Nationwide Pathology Databank and assessed for the presence of DCIS. Clinicopathologic factors associated with DCIS response were assessed using logistic regression analyses.
Results: A DCIS component was present in the pre-NST biopsy in 1403 (25.1%) of 5598 included patients. Pathologic complete response of the DCIS component was achieved in 730 patients (52.0%). Complete response of DCIS occurred more frequently in case of complete response of IBC (63.4% versus 33.8%, p < 0.001). ER-negative IBC (OR 1.79; 95%CI 1.33-2.42) and more recent years of diagnosis (2014-2016 OR 1.60; 95%CI 1.17-2.19, 2017-2019 OR 1.76; 95%CI 1.34-2.34) were associated with DCIS response. Mastectomy rates were higher in IBC+DCIS compared to IBC (53.6% versus 41.0%, p < 0.001).
Conclusion: Pathologic complete response of DCIS occurred in 52.0% of HER2-positive IBC patients and was associated with ER-negative IBC and more recent years of diagnosis. Future studies should investigate imaging evaluation of DCIS response to improve surgical decision making.
(© 2023. The Author(s).)
Databáze: MEDLINE
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