Surgical outcomes and prognosis of HER2+ invasive breast cancer patients with a DCIS component treated with breast-conserving surgery after neoadjuvant systemic therapy
In up to 72 % of HER2+ invasive breast cancer (IBC), a ductal carcinoma in situ (DCIS) component is present. The presence of DCIS is associated with increased positive surgical margins after breast-conserving surgery (BCS). The aim of this study was to assess surgical margins, recurrence and surviva...
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| Veröffentlicht in: | European journal of surgical oncology 2024-09, Vol.50 (9), p.108465, Article 108465 |
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| creator | Ploumen, Roxanne A.W. Claassens, Eva L. Kooreman, Loes F.S. Keymeulen, Kristien B.M.I. van Kats, Maartje A.C.E. van Kuijk, Sander M.J. Siesling, Sabine van Nijnatten, Thiemo J.A. Smidt, Marjolein L. |
| description | In up to 72 % of HER2+ invasive breast cancer (IBC), a ductal carcinoma in situ (DCIS) component is present. The presence of DCIS is associated with increased positive surgical margins after breast-conserving surgery (BCS). The aim of this study was to assess surgical margins, recurrence and survival in a nationwide cohort of HER2+ IBC with versus without a DCIS component, treated with neoadjuvant systemic therapy (NST) and BCS.
Women diagnosed with HER2+ IBC treated with NST and BCS, between 2010 and 2019, were selected from the Netherlands Cancer Registry and linked to the Dutch Nationwide Pathology Databank. Kaplan-Meier and Cox regression analyses were performed to determine locoregional recurrence rate (LRR) and overall survival (OS) and associated clinicopathological variables. Surgical outcomes and prognosis were compared between IBC only and IBC+DCIS.
A total of 3056 patients were included: 1832 with IBC and 1224 with IBC+DCIS. Patients with IBC+DCIS had significantly more often positive surgical margins compared to IBC (12.8 % versus 4.9 %, p |
| doi_str_mv | 10.1016/j.ejso.2024.108465 |
| format | Article |
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Women diagnosed with HER2+ IBC treated with NST and BCS, between 2010 and 2019, were selected from the Netherlands Cancer Registry and linked to the Dutch Nationwide Pathology Databank. Kaplan-Meier and Cox regression analyses were performed to determine locoregional recurrence rate (LRR) and overall survival (OS) and associated clinicopathological variables. Surgical outcomes and prognosis were compared between IBC only and IBC+DCIS.
A total of 3056 patients were included: 1832 with IBC and 1224 with IBC+DCIS. Patients with IBC+DCIS had significantly more often positive surgical margins compared to IBC (12.8 % versus 4.9 %, p < 0.001). Five-year LRR was significantly higher in patients with IBC+DCIS compared to IBC (6.8 % versus 3.6 %, p < 0.001), but the presence of DCIS itself was not significantly associated with LRR after adjusting for confounders in multivariable analysis. Five-year OS did not differ between IBC+DCIS and IBC (94.9 % versus 95.7 %, p = 0.293).
The presence of DCIS is associated with higher rates of positive surgical margins, but not with LRR and lower OS when adjusted for confounders. Further research is necessary to adequately select IBC+DCIS patients for BCS after NST.</description><identifier>ISSN: 0748-7983</identifier><identifier>ISSN: 1532-2157</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2024.108465</identifier><identifier>PMID: 38870869</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Ductal carcinoma in situ ; Invasive breast cancer ; Neoadjuvant systemic therapy ; Prognosis ; Surgical margins</subject><ispartof>European journal of surgical oncology, 2024-09, Vol.50 (9), p.108465, Article 108465</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-2a9440b5c8dc018898e76ad88da70c205305a3f5367cf2c168e61d7c86c41a73</cites><orcidid>0000-0003-1024-3519 ; 0000-0001-8226-8665 ; 0000-0002-0273-824X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0748798324005171$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38870869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ploumen, Roxanne A.W.</creatorcontrib><creatorcontrib>Claassens, Eva L.</creatorcontrib><creatorcontrib>Kooreman, Loes F.S.</creatorcontrib><creatorcontrib>Keymeulen, Kristien B.M.I.</creatorcontrib><creatorcontrib>van Kats, Maartje A.C.E.</creatorcontrib><creatorcontrib>van Kuijk, Sander M.J.</creatorcontrib><creatorcontrib>Siesling, Sabine</creatorcontrib><creatorcontrib>van Nijnatten, Thiemo J.A.</creatorcontrib><creatorcontrib>Smidt, Marjolein L.</creatorcontrib><title>Surgical outcomes and prognosis of HER2+ invasive breast cancer patients with a DCIS component treated with breast-conserving surgery after neoadjuvant systemic therapy</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>In up to 72 % of HER2+ invasive breast cancer (IBC), a ductal carcinoma in situ (DCIS) component is present. The presence of DCIS is associated with increased positive surgical margins after breast-conserving surgery (BCS). The aim of this study was to assess surgical margins, recurrence and survival in a nationwide cohort of HER2+ IBC with versus without a DCIS component, treated with neoadjuvant systemic therapy (NST) and BCS.
Women diagnosed with HER2+ IBC treated with NST and BCS, between 2010 and 2019, were selected from the Netherlands Cancer Registry and linked to the Dutch Nationwide Pathology Databank. Kaplan-Meier and Cox regression analyses were performed to determine locoregional recurrence rate (LRR) and overall survival (OS) and associated clinicopathological variables. Surgical outcomes and prognosis were compared between IBC only and IBC+DCIS.
A total of 3056 patients were included: 1832 with IBC and 1224 with IBC+DCIS. Patients with IBC+DCIS had significantly more often positive surgical margins compared to IBC (12.8 % versus 4.9 %, p < 0.001). Five-year LRR was significantly higher in patients with IBC+DCIS compared to IBC (6.8 % versus 3.6 %, p < 0.001), but the presence of DCIS itself was not significantly associated with LRR after adjusting for confounders in multivariable analysis. Five-year OS did not differ between IBC+DCIS and IBC (94.9 % versus 95.7 %, p = 0.293).
The presence of DCIS is associated with higher rates of positive surgical margins, but not with LRR and lower OS when adjusted for confounders. Further research is necessary to adequately select IBC+DCIS patients for BCS after NST.</description><subject>Ductal carcinoma in situ</subject><subject>Invasive breast cancer</subject><subject>Neoadjuvant systemic therapy</subject><subject>Prognosis</subject><subject>Surgical margins</subject><issn>0748-7983</issn><issn>1532-2157</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAUhSMEokPhBVggL5FQBv8ksSOxQUNpK1VCot1bHvtm6mgSB18naN6Ix8SjtCxZWbo-59yfryjeM7pllDWf-y30GLac8ioXVNXUL4oNqwUvOavly2JDZaVK2SpxUbxB7CmlrZDt6-JCKCWpatpN8ed-jgdvzZGEOdkwABIzOjLFcBgDeiShIzdXP_kn4sfFoF-A7CMYTMSa0UIkk0kexoTkt0-PxJBvu9t7koOmMOYySVmcwK2_q7O0YUSIix8PBHN3iCdiupSzRgjG9fNishFPmGDwlqRHiGY6vS1edeaI8O7pvSwevl897G7Kux_Xt7uvd6UVVKaSm7aq6L62ylnKlGoVyMY4pZyR1HJaC1ob0dWikbbjljUKGuakVY2tmJHisvi4xuYL_JoBkx48WjgeTR5uRi1oo2Rd0ZpnKV-lNgbECJ2eoh9MPGlG9RmQ7vUZkD4D0iugbPrwlD_vB3D_LM9EsuDLKoC85OIharT5wBacj2CTdsH_L_8vcO-lVw</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Ploumen, Roxanne A.W.</creator><creator>Claassens, Eva L.</creator><creator>Kooreman, Loes F.S.</creator><creator>Keymeulen, Kristien B.M.I.</creator><creator>van Kats, Maartje A.C.E.</creator><creator>van Kuijk, Sander M.J.</creator><creator>Siesling, Sabine</creator><creator>van Nijnatten, Thiemo J.A.</creator><creator>Smidt, Marjolein L.</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1024-3519</orcidid><orcidid>https://orcid.org/0000-0001-8226-8665</orcidid><orcidid>https://orcid.org/0000-0002-0273-824X</orcidid></search><sort><creationdate>20240901</creationdate><title>Surgical outcomes and prognosis of HER2+ invasive breast cancer patients with a DCIS component treated with breast-conserving surgery after neoadjuvant systemic therapy</title><author>Ploumen, Roxanne A.W. ; Claassens, Eva L. ; Kooreman, Loes F.S. ; Keymeulen, Kristien B.M.I. ; van Kats, Maartje A.C.E. ; van Kuijk, Sander M.J. ; Siesling, Sabine ; van Nijnatten, Thiemo J.A. ; Smidt, Marjolein L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-2a9440b5c8dc018898e76ad88da70c205305a3f5367cf2c168e61d7c86c41a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ductal carcinoma in situ</topic><topic>Invasive breast cancer</topic><topic>Neoadjuvant systemic therapy</topic><topic>Prognosis</topic><topic>Surgical margins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ploumen, Roxanne A.W.</creatorcontrib><creatorcontrib>Claassens, Eva L.</creatorcontrib><creatorcontrib>Kooreman, Loes F.S.</creatorcontrib><creatorcontrib>Keymeulen, Kristien B.M.I.</creatorcontrib><creatorcontrib>van Kats, Maartje A.C.E.</creatorcontrib><creatorcontrib>van Kuijk, Sander M.J.</creatorcontrib><creatorcontrib>Siesling, Sabine</creatorcontrib><creatorcontrib>van Nijnatten, Thiemo J.A.</creatorcontrib><creatorcontrib>Smidt, Marjolein L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ploumen, Roxanne A.W.</au><au>Claassens, Eva L.</au><au>Kooreman, Loes F.S.</au><au>Keymeulen, Kristien B.M.I.</au><au>van Kats, Maartje A.C.E.</au><au>van Kuijk, Sander M.J.</au><au>Siesling, Sabine</au><au>van Nijnatten, Thiemo J.A.</au><au>Smidt, Marjolein L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical outcomes and prognosis of HER2+ invasive breast cancer patients with a DCIS component treated with breast-conserving surgery after neoadjuvant systemic therapy</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>50</volume><issue>9</issue><spage>108465</spage><pages>108465-</pages><artnum>108465</artnum><issn>0748-7983</issn><issn>1532-2157</issn><eissn>1532-2157</eissn><abstract>In up to 72 % of HER2+ invasive breast cancer (IBC), a ductal carcinoma in situ (DCIS) component is present. The presence of DCIS is associated with increased positive surgical margins after breast-conserving surgery (BCS). The aim of this study was to assess surgical margins, recurrence and survival in a nationwide cohort of HER2+ IBC with versus without a DCIS component, treated with neoadjuvant systemic therapy (NST) and BCS.
Women diagnosed with HER2+ IBC treated with NST and BCS, between 2010 and 2019, were selected from the Netherlands Cancer Registry and linked to the Dutch Nationwide Pathology Databank. Kaplan-Meier and Cox regression analyses were performed to determine locoregional recurrence rate (LRR) and overall survival (OS) and associated clinicopathological variables. Surgical outcomes and prognosis were compared between IBC only and IBC+DCIS.
A total of 3056 patients were included: 1832 with IBC and 1224 with IBC+DCIS. Patients with IBC+DCIS had significantly more often positive surgical margins compared to IBC (12.8 % versus 4.9 %, p < 0.001). Five-year LRR was significantly higher in patients with IBC+DCIS compared to IBC (6.8 % versus 3.6 %, p < 0.001), but the presence of DCIS itself was not significantly associated with LRR after adjusting for confounders in multivariable analysis. Five-year OS did not differ between IBC+DCIS and IBC (94.9 % versus 95.7 %, p = 0.293).
The presence of DCIS is associated with higher rates of positive surgical margins, but not with LRR and lower OS when adjusted for confounders. Further research is necessary to adequately select IBC+DCIS patients for BCS after NST.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38870869</pmid><doi>10.1016/j.ejso.2024.108465</doi><orcidid>https://orcid.org/0000-0003-1024-3519</orcidid><orcidid>https://orcid.org/0000-0001-8226-8665</orcidid><orcidid>https://orcid.org/0000-0002-0273-824X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Ductal carcinoma in situ Invasive breast cancer Neoadjuvant systemic therapy Prognosis Surgical margins |
| title | Surgical outcomes and prognosis of HER2+ invasive breast cancer patients with a DCIS component treated with breast-conserving surgery after neoadjuvant systemic therapy |
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