The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis

IF 7.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY Breast Pub Date : 2025-04-01 Epub Date: 2025-02-18 DOI:10.1016/j.breast.2025.104425

Eva L. Claassens , Roxanne A.W. Ploumen , Loes F.S. Kooreman , Maartje A.C.E. van Kats , Sabine Siesling , Thiemo J.A. van Nijnatten , Marjolein L. Smidt

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Abstract

Purpose

Recent studies show that ductal carcinoma in situ (DCIS) accompanying HER2+ breast cancer can be completely eradicated following neoadjuvant systemic therapy in up to 52 %. We aimed to determine the complete response rate of DCIS in triple-negative breast cancer (TNBC) patients in a nationwide cohort and to assess clinicopathological variables associated with response. Furthermore, the impact on surgical treatment after neoadjuvant chemotherapy (NACT) was investigated.

Methods

Women diagnosed with TNBC, treated with NACT followed by surgery, between 2010 and 2020, were selected from the Netherlands Cancer Registry (NCR). Pre-NACT and postoperative pathology reports were obtained from Palga, the Dutch nationwide pathology databank, to determine presence of DCIS. Clinicopathological factors associated with DCIS response were investigated using uni- and multivariable logistic regression analysis.

Results

In total, 4494 patients were included. A DCIS component was present in the pre-NACT biopsy of 442 (9.8 %) patients. Pathologic complete response of the DCIS component was achieved in 53.6 % of these patients. The presence of calcifications in the pre-NACT biopsy was associated with a lower chance of DCIS response in univariable logistic regression analysis (OR 0.52, CI 95 % 0.27–0.98, p = 0.04). In multivariable analysis, no statistically significant associations were found between DCIS response and clinicopathological variables. Mastectomy rates were higher in case of IBC + DCIS compared to IBC (53.4 % vs 40.1 %, p < 0.001).

Conclusion

Pathologic complete response of DCIS to NACT occurred in 53.6 % of TNBC patients. Future studies are required to be able to predict DCIS response based on clinicopathological variables and imaging.

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新辅助化疗对三阴性乳腺癌原位导管癌患者的影响：一项全国性分析

最近的研究表明，导管原位癌（DCIS）伴HER2+乳腺癌在新辅助全身治疗后可完全根除高达52%。我们的目的是在全国队列中确定DCIS在三阴性乳腺癌（TNBC）患者中的完全缓解率，并评估与反应相关的临床病理变量。此外，研究了新辅助化疗（NACT）后对手术治疗的影响。方法从荷兰癌症登记处（NCR）中选择2010年至2020年期间诊断为TNBC，接受NACT治疗并进行手术的女性。从Palga（荷兰全国病理数据库）获取nact前和术后病理报告，以确定是否存在DCIS。应用单变量和多变量logistic回归分析研究与DCIS反应相关的临床病理因素。结果共纳入4494例患者。442例（9.8%）患者在nact前活检中发现DCIS成分。53.6%的患者实现了DCIS组件的病理完全缓解。单变量logistic回归分析显示，nact前活检中钙化的存在与DCIS反应的可能性较低相关（OR 0.52, CI 95% 0.27-0.98, p = 0.04）。在多变量分析中，没有发现DCIS反应与临床病理变量之间有统计学意义的关联。与IBC相比，IBC + DCIS的乳房切除术率更高(53.4% vs 40.1%, p <；0.001)。结论53.6%的TNBC患者DCIS对NACT的病理完全缓解。未来的研究需要能够基于临床病理变量和影像学来预测DCIS的反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.