Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment?
<i>Background and Objectives</i>: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant s...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/1/48 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832588006930776064 |
|---|---|
| author | Ebru Sen Mehmet Ali Nazlı Göktürk Maralcan Bekir Sıtkı Said Ulusoy Mahmut Kaan Demircioğlu Tuce Söylemez Akkurt Mehmet Sökücü Gökmen Umut Erdem Mustafa Yıldırım |
| author_facet | Ebru Sen Mehmet Ali Nazlı Göktürk Maralcan Bekir Sıtkı Said Ulusoy Mahmut Kaan Demircioğlu Tuce Söylemez Akkurt Mehmet Sökücü Gökmen Umut Erdem Mustafa Yıldırım |
| author_sort | Ebru Sen |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant systemic treatment (NST). Preoperative pathological identification of these exceptional responders is a new era. Therefore, we aimed to determine the accuracy of trucut biopsy in identifying the exceptional responders in selected molecular subtypes of breast cancer patients. <i>Materials and Methods</i>: This two-centre, observational, single-arm, prospective, pilot study was conducted between January and September 2024. The patients with TN or HER2 positive breast cancer whose breast tumour had completely disappeared on the radiological assessment including MRI after neoadjuvant therapy were enrolled. To assess neoadjuvant treatment response, a standardised biopsy protocol was used, consisting of 10 samples from the marked tumour area per patient by 12 G core needle. Then, all patients underwent surgery. The pathological results of both postchemo-presurgical biopsy and surgical breast specimen were compared. <i>Results</i>: The study included 20 patients. The mean age of the patients was 47.3 years. The median tumour size at diagnosis was 23.1 mm. All biopsy results were concordant with the findings of surgical specimen. Seventeen patients had a complete response. The remaining 3 patients had residual disease. <i>Conclusions</i>: Along with thorough patient selection, post-chemo radiological assessment and the reliable biopsy technique are the key points in accurately predicting response to neoadjuvant treatment. If an image-guided core biopsy confirms elimination of tumour tissue at the marked tumour area with a radiological complete response on MRI after NST in breast cancer patients with selected molecular subtypes, these may be suitable patients as exceptional responders in whom we can omit breast surgery. |
| format | Article |
| id | doaj-art-997be5f24e2842c5889782519389645c |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-997be5f24e2842c5889782519389645c2025-01-24T13:40:22ZengMDPI AGMedicina1010-660X1648-91442024-12-016114810.3390/medicina61010048Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment?Ebru Sen0Mehmet Ali Nazlı1Göktürk Maralcan2Bekir Sıtkı Said Ulusoy3Mahmut Kaan Demircioğlu4Tuce Söylemez Akkurt5Mehmet Sökücü6Gökmen Umut Erdem7Mustafa Yıldırım8Department of General Surgery, Başakşehir Çam and Sakura City Hospital İstanbul Türkiye, Istanbul 34480, TürkiyeInterventional Radiology Section, Department of Radiology, Başakşehir Çam and Sakura City Hospital İstanbul Türkiye, Istanbul 34480, TürkiyeDepartment of General Surgery, Section of Endocrine and Breast Surgery, Sanko University Medical Faculty Gaziantep Türkiye, Gaziantep 27090, TürkiyeSection of Interventional Radiology, Department of Radiology, Sanko University Medical Faculty Gaziantep Türkiye, Gaziantep 27090, TürkiyeDepartment of Surgical Oncology, Başakşehir Çam and Sakura City Hospital İstanbul Türkiye, İstanbul 34480, TürkiyeDepartment of Pathology, Başakşehir Çam and Sakura City Hospital İstanbul Türkiye, İstanbul 34480, TürkiyeDepartment of Pathology, Sanko University Medical Faculty Gaziantep Türkiye, Gaziantep 27090, TürkiyeDepartment of Medical Oncology, Başakşehir Çam and Sakura City Hospital İstanbul Türkiye, İstanbul 34480, TürkiyeDepartment of Medical Oncology, Sanko University Medical Faculty Gaziantep Türkiye, Gaziantep 27090, Türkiye<i>Background and Objectives</i>: Among breast cancer molecular types, HER2 positive and triple negative (TN) subtypes have the highest likelihood of pathological complete response (pCR), which is a surrogate marker for reduced recurrence and improved patient survival after neoadjuvant systemic treatment (NST). Preoperative pathological identification of these exceptional responders is a new era. Therefore, we aimed to determine the accuracy of trucut biopsy in identifying the exceptional responders in selected molecular subtypes of breast cancer patients. <i>Materials and Methods</i>: This two-centre, observational, single-arm, prospective, pilot study was conducted between January and September 2024. The patients with TN or HER2 positive breast cancer whose breast tumour had completely disappeared on the radiological assessment including MRI after neoadjuvant therapy were enrolled. To assess neoadjuvant treatment response, a standardised biopsy protocol was used, consisting of 10 samples from the marked tumour area per patient by 12 G core needle. Then, all patients underwent surgery. The pathological results of both postchemo-presurgical biopsy and surgical breast specimen were compared. <i>Results</i>: The study included 20 patients. The mean age of the patients was 47.3 years. The median tumour size at diagnosis was 23.1 mm. All biopsy results were concordant with the findings of surgical specimen. Seventeen patients had a complete response. The remaining 3 patients had residual disease. <i>Conclusions</i>: Along with thorough patient selection, post-chemo radiological assessment and the reliable biopsy technique are the key points in accurately predicting response to neoadjuvant treatment. If an image-guided core biopsy confirms elimination of tumour tissue at the marked tumour area with a radiological complete response on MRI after NST in breast cancer patients with selected molecular subtypes, these may be suitable patients as exceptional responders in whom we can omit breast surgery.https://www.mdpi.com/1648-9144/61/1/48neoadjuvant therapyomission of surgerypostchemo-presurgical core biopsy |
| spellingShingle | Ebru Sen Mehmet Ali Nazlı Göktürk Maralcan Bekir Sıtkı Said Ulusoy Mahmut Kaan Demircioğlu Tuce Söylemez Akkurt Mehmet Sökücü Gökmen Umut Erdem Mustafa Yıldırım Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? Medicina neoadjuvant therapy omission of surgery postchemo-presurgical core biopsy |
| title | Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? |
| title_full | Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? |
| title_fullStr | Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? |
| title_full_unstemmed | Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? |
| title_short | Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment? |
| title_sort | who are suitable patients for omitting breast surgery as an exceptional responder in selected molecular subtypes of breast cancer after neoadjuvant systemic treatment |
| topic | neoadjuvant therapy omission of surgery postchemo-presurgical core biopsy |
| url | https://www.mdpi.com/1648-9144/61/1/48 |
| work_keys_str_mv | AT ebrusen whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT mehmetalinazlı whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT gokturkmaralcan whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT bekirsıtkısaidulusoy whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT mahmutkaandemircioglu whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT tucesoylemezakkurt whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT mehmetsokucu whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT gokmenumuterdem whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment AT mustafayıldırım whoaresuitablepatientsforomittingbreastsurgeryasanexceptionalresponderinselectedmolecularsubtypesofbreastcancerafterneoadjuvantsystemictreatment |