Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes

Joel Allotey; Vinita Ruparel; Anna McCallum; Karendeep Somal; Louise Simpson; Gaurav Gupta; Gerald Lip; Ravi Sharma; Yazan Masannat

doi:10.1016/j.ejso.2024.108781

Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes

Joel Allotey^* (Corresponding Author), Vinita Ruparel, Anna McCallum, Karendeep Somal, Louise Simpson, Gaurav Gupta, Gerald Lip, Ravi Sharma, Yazan Masannat

^*Corresponding author for this work

Applied Medicine

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Abstract

Residual microcalcifications on mammograms after neoadjuvant chemotherapy (NACT) pose a challenge in surgical decision-making. This single-centre retrospective review of all patients who had NACT for breast cancer over five years, evaluated the relationship between pathological complete response and residual microcalcifications, controlling for tumour size, nodal stage, grade, and receptor status, as well as the impact of residual microcalcifications on recurrence and survival. There was no significant association between pathological complete response (pCR) and residual microcalcifications (p = 0.763). We computed hazard ratios (HR) for Time to recurrence (TTR) and overall survival (OS) which were both not significant, with HR = 2.599, [0.290, 23.264], p = 0.393 and HR = 1.362 [0.123, 15.062], p = 0.801 respectively. The predictive and prognostic significance of residual microcalcifications remains to be proven. The surgical excision of these lesions should be considered based on individual patient risk.

Original language	English
Article number	108781
Journal	European Journal of Surgical Oncology
Volume	51
Issue number	1
Early online date	31 Oct 2024
DOIs	https://doi.org/10.1016/j.ejso.2024.108781
Publication status	Published - Jan 2025

Bibliographical note

CRediT authorship contribution statement
Joel Allotey: were responsible for data collection, was responsible for writing, data management, Formal analysis, Project administration. Vinita Ruparel: were responsible for data collection. Anna McCallum: were responsible for data collection. Karendeep Somal: were responsible for data collection. Louise Simpson: were responsible for critical review of the manuscript. Gaurav Gupta: were responsible for critical review of the manuscript. Gerald Lip: were responsible for critical review of the manuscript. Ravi Sharma: contributed the, Conceptualization, of the project and provided, Supervision, were responsible for critical review of the manuscript. Yazan Masannat: contributed the, Conceptualization, of the project and provided, Supervision, were responsible for critical review of the manuscript.

Funding

No funding declared

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Allotey, J., Ruparel, V., McCallum, A., Somal, K., Simpson, L., Gupta, G., Lip, G., Sharma, R., & Masannat, Y. (2025). Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes. European Journal of Surgical Oncology, 51(1), Article 108781. https://doi.org/10.1016/j.ejso.2024.108781

Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes. / Allotey, Joel (Corresponding Author); Ruparel, Vinita; McCallum, Anna et al.
In: European Journal of Surgical Oncology, Vol. 51, No. 1, 108781, 01.2025.

Research output: Contribution to journal › Article › peer-review

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abstract = "Residual microcalcifications on mammograms after neoadjuvant chemotherapy (NACT) pose a challenge in surgical decision-making. This single-centre retrospective review of all patients who had NACT for breast cancer over five years, evaluated the relationship between pathological complete response and residual microcalcifications, controlling for tumour size, nodal stage, grade, and receptor status, as well as the impact of residual microcalcifications on recurrence and survival. There was no significant association between pathological complete response (pCR) and residual microcalcifications (p = 0.763). We computed hazard ratios (HR) for Time to recurrence (TTR) and overall survival (OS) which were both not significant, with HR = 2.599, [0.290, 23.264], p = 0.393 and HR = 1.362 [0.123, 15.062], p = 0.801 respectively. The predictive and prognostic significance of residual microcalcifications remains to be proven. The surgical excision of these lesions should be considered based on individual patient risk.",

author = "Joel Allotey and Vinita Ruparel and Anna McCallum and Karendeep Somal and Louise Simpson and Gaurav Gupta and Gerald Lip and Ravi Sharma and Yazan Masannat",

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N2 - Residual microcalcifications on mammograms after neoadjuvant chemotherapy (NACT) pose a challenge in surgical decision-making. This single-centre retrospective review of all patients who had NACT for breast cancer over five years, evaluated the relationship between pathological complete response and residual microcalcifications, controlling for tumour size, nodal stage, grade, and receptor status, as well as the impact of residual microcalcifications on recurrence and survival. There was no significant association between pathological complete response (pCR) and residual microcalcifications (p = 0.763). We computed hazard ratios (HR) for Time to recurrence (TTR) and overall survival (OS) which were both not significant, with HR = 2.599, [0.290, 23.264], p = 0.393 and HR = 1.362 [0.123, 15.062], p = 0.801 respectively. The predictive and prognostic significance of residual microcalcifications remains to be proven. The surgical excision of these lesions should be considered based on individual patient risk.

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Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes

Abstract

Bibliographical note

Funding

UN SDGs

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