Sicheng Zhou, Li Liang, Zehao Huang, Yue Teng, Wei Xing
{"title":"伴发导管原位癌是否影响三阴性浸润性导管癌新辅助治疗后的预后？","authors":"Sicheng Zhou, Li Liang, Zehao Huang, Yue Teng, Wei Xing","doi":"10.1186/s12957-025-03753-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Ductal carcinoma in situ (DCIS) is considered a precursor to invasive ductal carcinoma (IDC), and the coexistence of DCIS with IDC is often observed during the diagnosis of breast cancer. The aim of study is to investigated the clinicopathological features and prognosis of triple-negative IDC with DCIS following neoadjuvant therapy (NAT). Additionally, we explored the risk factors for residual DCIS in these patients post-NAT.</p><p><strong>Methods: </strong>This study included patients with stages II-III triple-negative breast cancer with histologically confirmed IDC who underwent radical surgery after NAT between January 2011 and December 2021. Baseline data, clinical features, pathological outcomes, and prognostic information were collected and analyzed.</p><p><strong>Results: </strong>A total of 315 patients were enrolled and categorized into the IDC + DCIS (n = 67) and IDC groups (n = 248) according to the composition of the pre-NAT biopsy. The proportion of patients with histological grade G3 (78.2% vs. 61.2%, p = 0.004) and a Ki-67 index > 20% (98.4% vs. 86.6%, p < 0.001) was significantly higher in the IDC group than in the IDC + DCIS group. Although no significant difference was observed in the 5-year overall survival (OS) (93.4% vs. 90.8%, p = 0.298) between the two groups, the 5-year disease-free survival (DFS) (90.6% vs. 83.5%, p = 0.041) of the IDC + DCIS group was significantly better than that in the IDC group. Multivariate analysis demonstrated that IDC + DCIS (HR: 0.502; 95% CI, 0.284-0.952; p = 0.048) was an independent prognostic factor for DFS. In addition, the clinical T3-T4 stage (OR = 3.891; 95% CI, 1.320-15.219, p = 0.040) and clinical N1-N3 (OR = 4.500; 95% CI, 1.495-13.564, p = 0.012) were independent preoperative predictors of residual DCIS after NAT in patients with IDC and DCIS components.</p><p><strong>Conclusion: </strong>The presence of DCIS component in patients with triple-negative IDC is associated with lower tumor aggressiveness and improved DFS after NAT compared to patients without DCIS. Additionally, clinical T and N stages are risk factors for residual DCIS after NAT in patients with triple-negative IDC and a DCIS component.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"101"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934604/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does concomitant ductal carcinoma in situ influence the prognostic outcome after neoadjuvant therapy in triple-negative invasive ductal carcinoma?\",\"authors\":\"Sicheng Zhou, Li Liang, Zehao Huang, Yue Teng, Wei Xing\",\"doi\":\"10.1186/s12957-025-03753-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Ductal carcinoma in situ (DCIS) is considered a precursor to invasive ductal carcinoma (IDC), and the coexistence of DCIS with IDC is often observed during the diagnosis of breast cancer. The aim of study is to investigated the clinicopathological features and prognosis of triple-negative IDC with DCIS following neoadjuvant therapy (NAT). Additionally, we explored the risk factors for residual DCIS in these patients post-NAT.</p><p><strong>Methods: </strong>This study included patients with stages II-III triple-negative breast cancer with histologically confirmed IDC who underwent radical surgery after NAT between January 2011 and December 2021. Baseline data, clinical features, pathological outcomes, and prognostic information were collected and analyzed.</p><p><strong>Results: </strong>A total of 315 patients were enrolled and categorized into the IDC + DCIS (n = 67) and IDC groups (n = 248) according to the composition of the pre-NAT biopsy. The proportion of patients with histological grade G3 (78.2% vs. 61.2%, p = 0.004) and a Ki-67 index > 20% (98.4% vs. 86.6%, p < 0.001) was significantly higher in the IDC group than in the IDC + DCIS group. Although no significant difference was observed in the 5-year overall survival (OS) (93.4% vs. 90.8%, p = 0.298) between the two groups, the 5-year disease-free survival (DFS) (90.6% vs. 83.5%, p = 0.041) of the IDC + DCIS group was significantly better than that in the IDC group. Multivariate analysis demonstrated that IDC + DCIS (HR: 0.502; 95% CI, 0.284-0.952; p = 0.048) was an independent prognostic factor for DFS. In addition, the clinical T3-T4 stage (OR = 3.891; 95% CI, 1.320-15.219, p = 0.040) and clinical N1-N3 (OR = 4.500; 95% CI, 1.495-13.564, p = 0.012) were independent preoperative predictors of residual DCIS after NAT in patients with IDC and DCIS components.</p><p><strong>Conclusion: </strong>The presence of DCIS component in patients with triple-negative IDC is associated with lower tumor aggressiveness and improved DFS after NAT compared to patients without DCIS. 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引用次数: 0
摘要
目的：导管原位癌（Ductal carcinoma in situ， DCIS）被认为是浸润性导管癌（invasive Ductal carcinoma， IDC）的前兆，在乳腺癌的诊断过程中，DCIS与IDC共存的情况经常被观察到。本研究旨在探讨三阴性IDC合并DCIS经新辅助治疗（NAT）后的临床病理特征及预后。此外，我们还探讨了这些患者术后DCIS残留的危险因素。方法：本研究纳入2011年1月至2021年12月期间经组织学证实的II-III期三阴性乳腺癌IDC患者，这些患者在NAT后接受根治性手术。收集和分析基线数据、临床特征、病理结果和预后信息。结果：共纳入315例患者，根据nat前活检组成分为IDC + DCIS组（n = 67）和IDC组（n = 248）。组织学分级为G3的患者比例（78.2% vs. 61.2%, p = 0.004）， Ki-67指数为>的患者比例为20% （98.4% vs. 86.6%, p）。结论：三阴性IDC患者与无DCIS患者相比，DCIS成分的存在与NAT后肿瘤侵袭性降低和DFS改善相关。此外，临床T和N分期是三阴性IDC和DCIS组件患者NAT后残留DCIS的危险因素。
Does concomitant ductal carcinoma in situ influence the prognostic outcome after neoadjuvant therapy in triple-negative invasive ductal carcinoma?
Purpose: Ductal carcinoma in situ (DCIS) is considered a precursor to invasive ductal carcinoma (IDC), and the coexistence of DCIS with IDC is often observed during the diagnosis of breast cancer. The aim of study is to investigated the clinicopathological features and prognosis of triple-negative IDC with DCIS following neoadjuvant therapy (NAT). Additionally, we explored the risk factors for residual DCIS in these patients post-NAT.
Methods: This study included patients with stages II-III triple-negative breast cancer with histologically confirmed IDC who underwent radical surgery after NAT between January 2011 and December 2021. Baseline data, clinical features, pathological outcomes, and prognostic information were collected and analyzed.
Results: A total of 315 patients were enrolled and categorized into the IDC + DCIS (n = 67) and IDC groups (n = 248) according to the composition of the pre-NAT biopsy. The proportion of patients with histological grade G3 (78.2% vs. 61.2%, p = 0.004) and a Ki-67 index > 20% (98.4% vs. 86.6%, p < 0.001) was significantly higher in the IDC group than in the IDC + DCIS group. Although no significant difference was observed in the 5-year overall survival (OS) (93.4% vs. 90.8%, p = 0.298) between the two groups, the 5-year disease-free survival (DFS) (90.6% vs. 83.5%, p = 0.041) of the IDC + DCIS group was significantly better than that in the IDC group. Multivariate analysis demonstrated that IDC + DCIS (HR: 0.502; 95% CI, 0.284-0.952; p = 0.048) was an independent prognostic factor for DFS. In addition, the clinical T3-T4 stage (OR = 3.891; 95% CI, 1.320-15.219, p = 0.040) and clinical N1-N3 (OR = 4.500; 95% CI, 1.495-13.564, p = 0.012) were independent preoperative predictors of residual DCIS after NAT in patients with IDC and DCIS components.
Conclusion: The presence of DCIS component in patients with triple-negative IDC is associated with lower tumor aggressiveness and improved DFS after NAT compared to patients without DCIS. Additionally, clinical T and N stages are risk factors for residual DCIS after NAT in patients with triple-negative IDC and a DCIS component.
期刊介绍：
World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics.
Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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