br To our knowledge this is one of the largest
To our knowledge, this is one of the largest studies on a nationwide level demonstrating a trend of more BCS after NAC in relation to surgical outcomes. However, our study is limited by the retrospective nature and incomplete information on tumour response after NAC. Also, we were unable to retrospectively
determine the percentage of patients eligible for BCS at the time of diagnosis.
Conclusion
The increasing implementation of NAC have led to an increase in ‘BCS after NAC’ in the Netherlands between 2011 and 2016. Moreover, this nationwide data confirms that BCS after NAC re-sults in equal surgical outcomes for cT2 and improved surgical outcomes for cT3 invasive breast cancer compared to primary BCS. In view of the trend towards de-escalation of surgical treatment in selected patients with excellent pathologic response, these promising results confirm that clinicians are increasingly able to perform ‘BCS after NAC’ while maintaining good surgical outcomes.
Table A (continued )
Hormone 127274-91-3 status
Type of hospital
Hospital surgical volume
Authors’ contributions
All persons listed as authors were actively involved in one or more key aspects of the reported study. P.E.R.S. d conception, design and acquisition of data, and analysis and interpretation of data; drafting the article; final approval. J.H.V. d conception and design, and analysis and interpretation of data; revising critically; final approval. P.T. dinterpretation of data; revising critically; final approval. C.H.S.d design; interpretation of data; revising critically; final approval. M.T.F.D.V.P.ddesign, interpretation of data; revising critically; final approval.
Conflict of interest
The authors declare that there is no conflict of interest.
Appendices
Table A
Clinical-pathological and hospital characteristics of cT1-4M0 breast cancer patients (N ¼ 36.475) who have received breast conserving surgery with or without chemotherapy upfront (2012e2016).
Year of incidence
Age
Histologic subtype
DCIS component
Clinical tumour stage
Clinical nodal stage
Table B
Clinical-pathological and hospital characteristics associated with tumour free mar-gins in cT1-4M0 breast cancer patients who have received breast conserving surgery after neoadjuvant chemotherapy (N ¼ 4116).
No involved
Involved
margins
margins
Year of incidence
Age
Histologic subtype
DCIS component
Clinical tumour stage
Clinical nodal stage
Hormone receptor status
Type of hospital
Hospital surgical volume
References
[6] Caudle AS, Yang WT, Krishnamurthy S, et al. Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection. J Clin Oncol 2016;34(10):1072e8. https://doi.org/10.1200/ JCO.2015.64.0094.
[13] Vrancken Peeters MJ. Towards omitting breast cancer surgery in patients without residual tumor after upfront chemotherapy [Nederlands Trial Regis-ter web site]. Available at: http://www.trialregister.nl/trialreg/admin/rctview. asp?TC¼6120. [Accessed 10 July 2018].
[14] Kuerer HM, Peeters MTFD, Rea DW, et al. Nonoperative management for invasive breast cancer after neoadjuvant systemic therapy: conceptual basis and fundamental international feasibility clinical trials. Ann Surg Oncol 2017;24(10):2855e62. https://doi.org/10.1245/s10434-017-5926-z.
[15] Van Der Noordaa MEM, Duijnhoven FH, Van Loo CE, et al. Identifying path-ologic complete response of the breast after neoadjuvant systemic therapy with ultrasound guided biopsy to eventually omit surgery: study design and feasibility of the MICRA trial. Breast 2018;23(40):76e81. https://doi.org/ 10.1016/j.breast.2018.04.015.
[18] Dutch national breast cancer guideline [Oncoline richtlijn version 2.0, 2012 web site]. Available at: http://www.oncoline.nl/mammacarcinoom. Accessed 10 July 2018.
Contents lists available at ScienceDirect
European Journal of Radiology
journal homepage: www.elsevier.com/locate/ejrad
Research article
Breast MRI background parenchymal enhancement as an imaging bridge to T molecular cancer sub-type
Giuseppe Dilorenzoa, Michele Telegrafoa, Daniele La Forgiab, Amato Antonio Stabile Ianorac, Marco Moschettaa,
a D.E.T.O., Department of Emergency and Organ Transplantations, Breast Unit- University of Bari Medical School, Italy
b I.R.C.C.S. "Giovanni Paolo II" National Cancer Ctr Bari, Italy
c D.I.M., Interdisciplinary Department of Medicine, University of Bari Medical School, Italy