Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component
Background: The presence of a DCIS component accompanying invasive breast cancer (IBC) is associated with a higher rate of primary mastectomy compared to IBC without DCIS. After neoadjuvant systemic therapy (NST), HER2+ IBC patients show high response rates, allowing for increasing breast-conserving...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977624001851 |
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| author | Roxanne A.W. Ploumen Thiemo J.A. van Nijnatten Loes F.S. Kooreman Adri C. Voogd Kristien B.M.I. Keymeulen Sabine Siesling Marjolein L. Smidt |
| author_facet | Roxanne A.W. Ploumen Thiemo J.A. van Nijnatten Loes F.S. Kooreman Adri C. Voogd Kristien B.M.I. Keymeulen Sabine Siesling Marjolein L. Smidt |
| author_sort | Roxanne A.W. Ploumen |
| collection | DOAJ |
| description | Background: The presence of a DCIS component accompanying invasive breast cancer (IBC) is associated with a higher rate of primary mastectomy compared to IBC without DCIS. After neoadjuvant systemic therapy (NST), HER2+ IBC patients show high response rates, allowing for increasing breast-conserving surgery rates. The aim of this study was to examine surgical trends after NST in a Dutch nationwide HER2+ cohort, and the influence of a DCIS component on mastectomy rate. Methods: Women with HER2+ IBC, diagnosed between 2010 and 2019 and treated with NST and surgery were included from the Netherlands Cancer Registry. Mastectomy rate was examined over the years, and compared between patients with and without a DCIS component in the pre-NST biopsy. Multivariable logistic regression analysis was used to investigate the association of the DCIS component with mastectomy rate and likelihood of achieving ypT0. Results: In total, 5289 patients were included. Over 10 years, mastectomy rate significantly decreased from 62.6 % in 2010 to 35.1 % in 2019. Patients with IBC+DCIS more often underwent mastectomy, with a rate of 48.4 % in 2019, compared to 30.0 % in IBC only (p < 0.001). Percentage of ypT0 was significantly lower in patients with IBC+DCIS (38.7 %), compared to IBC only (47.3 %, p < 0.001) Multivariable logistic regression analyses showed presence of DCIS (OR 1.69, 95%CI 1.47–1.95, p < 0.001) to be independently associated with mastectomy. Conclusion: Rate of mastectomy decreased significantly in HER2+ IBC treated with NST between 2010 and 2019. Presence of DCIS in the biopsy remained associated with higher mastectomy rate, yet 38.7 % of these patients do achieve ypT0. |
| format | Article |
| id | doaj-art-2c9c4eb56989433b903d58c1ac2b291e |
| institution | Kabale University |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-2c9c4eb56989433b903d58c1ac2b291e2025-02-12T05:30:34ZengElsevierBreast1532-30802025-02-0179103854Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS componentRoxanne A.W. Ploumen0Thiemo J.A. van Nijnatten1Loes F.S. Kooreman2Adri C. Voogd3Kristien B.M.I. Keymeulen4Sabine Siesling5Marjolein L. Smidt6Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands; Corresponding author. Department of Surgery, Maastricht University Medical Centre+, P.O. Box 5800, 6202, AZ, Maastricht, the Netherlands.GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, the NetherlandsGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Centre+, Maastricht, the NetherlandsDepartment of Epidemiology, Maastricht University, Maastricht, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the NetherlandsDepartment of Surgery, Maastricht University Medical Centre+, Maastricht, the NetherlandsDepartment of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the NetherlandsDepartment of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; GROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the NetherlandsBackground: The presence of a DCIS component accompanying invasive breast cancer (IBC) is associated with a higher rate of primary mastectomy compared to IBC without DCIS. After neoadjuvant systemic therapy (NST), HER2+ IBC patients show high response rates, allowing for increasing breast-conserving surgery rates. The aim of this study was to examine surgical trends after NST in a Dutch nationwide HER2+ cohort, and the influence of a DCIS component on mastectomy rate. Methods: Women with HER2+ IBC, diagnosed between 2010 and 2019 and treated with NST and surgery were included from the Netherlands Cancer Registry. Mastectomy rate was examined over the years, and compared between patients with and without a DCIS component in the pre-NST biopsy. Multivariable logistic regression analysis was used to investigate the association of the DCIS component with mastectomy rate and likelihood of achieving ypT0. Results: In total, 5289 patients were included. Over 10 years, mastectomy rate significantly decreased from 62.6 % in 2010 to 35.1 % in 2019. Patients with IBC+DCIS more often underwent mastectomy, with a rate of 48.4 % in 2019, compared to 30.0 % in IBC only (p < 0.001). Percentage of ypT0 was significantly lower in patients with IBC+DCIS (38.7 %), compared to IBC only (47.3 %, p < 0.001) Multivariable logistic regression analyses showed presence of DCIS (OR 1.69, 95%CI 1.47–1.95, p < 0.001) to be independently associated with mastectomy. Conclusion: Rate of mastectomy decreased significantly in HER2+ IBC treated with NST between 2010 and 2019. Presence of DCIS in the biopsy remained associated with higher mastectomy rate, yet 38.7 % of these patients do achieve ypT0.http://www.sciencedirect.com/science/article/pii/S0960977624001851Surgical treatmentNeoadjuvant systemic therapyNationwide dataInvasive breast cancerDuctal carcinoma in situ |
| spellingShingle | Roxanne A.W. Ploumen Thiemo J.A. van Nijnatten Loes F.S. Kooreman Adri C. Voogd Kristien B.M.I. Keymeulen Sabine Siesling Marjolein L. Smidt Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component Breast Surgical treatment Neoadjuvant systemic therapy Nationwide data Invasive breast cancer Ductal carcinoma in situ |
| title | Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component |
| title_full | Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component |
| title_fullStr | Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component |
| title_full_unstemmed | Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component |
| title_short | Surgical treatment after neoadjuvant systemic therapy for HER2-positive invasive breast cancer in the Netherlands: 10-Year trends and the influence an accompanying DCIS component |
| title_sort | surgical treatment after neoadjuvant systemic therapy for her2 positive invasive breast cancer in the netherlands 10 year trends and the influence an accompanying dcis component |
| topic | Surgical treatment Neoadjuvant systemic therapy Nationwide data Invasive breast cancer Ductal carcinoma in situ |
| url | http://www.sciencedirect.com/science/article/pii/S0960977624001851 |
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