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  • br To our knowledge this is one of the largest

    2020-08-24


    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 127274-91-3 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