The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis
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 nationw...
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| Format: | Article |
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Elsevier
2025-04-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S096097762500044X |
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| author | 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 |
| author_facet | 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 |
| author_sort | Eva L. Claassens |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-b8bfba8dfc8048308e0fd043965e567a |
| institution | Kabale University |
| issn | 1532-3080 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj-art-b8bfba8dfc8048308e0fd043965e567a2025-08-20T03:42:56ZengElsevierBreast1532-30802025-04-018010442510.1016/j.breast.2025.104425The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysisEva L. Claassens0Roxanne A.W. Ploumen1Loes F.S. Kooreman2Maartje A.C.E. van Kats3Sabine Siesling4Thiemo J.A. van Nijnatten5Marjolein L. Smidt6Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; GROW – Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Corresponding author. Department of Surgery Maastricht University Medical Centre+ P.O. Box 616 6200 MD Maastricht the Netherlands.Department of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; GROW – Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the NetherlandsGROW – Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Centre+, Maastricht, the NetherlandsDepartment of Medical Oncology, Maastricht University Medical Centre+, Maastricht, the NetherlandsDepartment of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the NetherlandsGROW – Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, the NetherlandsDepartment of Surgery, Maastricht University Medical Centre+, Maastricht, the Netherlands; GROW – Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the NetherlandsPurpose: 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.http://www.sciencedirect.com/science/article/pii/S096097762500044XDuctal carcinoma in situNeoadjuvant chemotherapyPathologic complete responseTriple-negative breast cancer |
| spellingShingle | 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 The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis Breast Ductal carcinoma in situ Neoadjuvant chemotherapy Pathologic complete response Triple-negative breast cancer |
| title | The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis |
| title_full | The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis |
| title_fullStr | The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis |
| title_full_unstemmed | The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis |
| title_short | The effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple-negative breast cancer patients: A nationwide analysis |
| title_sort | effect of neoadjuvant chemotherapy on ductal carcinoma in situ in triple negative breast cancer patients a nationwide analysis |
| topic | Ductal carcinoma in situ Neoadjuvant chemotherapy Pathologic complete response Triple-negative breast cancer |
| url | http://www.sciencedirect.com/science/article/pii/S096097762500044X |
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