Roxanne Ploumen on LinkedIn: Surgical outcomes and prognosis of HER2+ invasive breast cancer patients… (2024)

Last week we went to the 42nd Congress of the European Society of Surgical Oncology in Florence by train. It was a comfortable and beautiful journey, even more than we had expected beforehand. Definitely worth considering for future congresses. In Florence, I had the opportunity to present our recent results on surgical outcomes and prognosis of HER2+ invasive breast cancer with a DCIS component. After treatment with neoadjuvant systemic therapy and breast-conserving surgery, HER2+ invasive breast cancer patients with a DCIS component had, compared to patients with invasive breast cancer only:- a higher rate of positive surgical margins- a higher rate of locoregional recurrence- a worse locoregional recurrence free survival, however, due to other factors than the DCIS component (e.g. a lower rate of complete response of the invasive tumour).Since our previous research shows that the DCIS component can completely disappear after neoadjuvant treatment in 50% of patients, more research in the prediction and detection of this response is necessary to improve surgical treatment.I would like to thank IKNL (Integraal Kankercentrum Nederland) and Palga Foundation for the collection of this database, and all the co-authors, Eva Claassens, Loes Kooreman, Kristien Keymeulen, Maartje van Kats, Sander van Kuijk, Sabine Siesling, Thiemo van Nijnatten and Marjolein Smidt for their help.Moreover, thanks to my fellow train travelers Sabine de Wild, Melissa Lenaerts and Florien van Amstel, it was totally worth it.#DCIS #invasivebreastcancer #neoadjucantsystematictherapy #esso42 #Florence

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Yesterday our nationwide study on the pathologic complete response of ductal carcinoma in situ to neoadjuvant systemic therapy was published in Breast Cancer Research and Treatment. Ductal carcinoma in situ (DCIS) is present in more than half of HER2-positive invasive breast cancer patients, a population that is often treated with neoadjuvant systemic therapy (NST). One of the advantages of NST is downsizing the tumor, in order to increase the chance of breast-conserving therapy. Unfortunately, previous studies, and our current results, show that patients with a DCIS component more often undergo mastectomy. A possible reason could be that the DCIS component is not considered to be responsive to NST. In our nationwide cohort of 1403 HER2+ invasive breast cancer patients, a pathologic complete response of the DCIS component was achieved in 52%. The complete response of DCIS was associated with complete response of the invasive tumor, ER negativity of the invasive tumor, and a later year of diagnosis. We are very pleased to share these interesting results and thereby raise awareness about this subject. Future studies are necessary to investigate imaging evaluation of DCIS response to improve surgical decision making.I would like to thank my research team for their support and contribution to this publication. Eva Claassens, Loes Kooreman, Kristien Keymeulen, Maartje van Kats, Suzanne Gommers, Sabine Siesling, Thiemo van Nijnatten and Marjolein Smidt.https://lnkd.in/eeeeze5v

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Afgelopen vrijdag mocht ik de resultaten van onze systematic review over beeldvorming van DCIS bij invasief mammacarcinoom gedurende neoadjuvante therapie presenteren op de Chirurgendagen van de Nederlandse Vereniging voor Heelkunde. Recente literatuur laat zien dat tot wel 50% van DCIS bij invasief mammacarcinoom volledig kan responderen op neoadjuvante systemische therapie (NST). Om uiteindelijk deze patiënten de meest optimale chirurgische behandeling aan te bieden is beeldvorming van belang in het evalueren van deze repons.Onze systematic review laat zien dat er tot op heden nog maar weinig studies de beeldvorming van DCIS bij invasief mammacarcinoom onderzoeken. De belangrijkste resultaten uit de 31 geïncludeerde studies zijn:- Calcificaties op mammografie kunnen blijven bestaan na NST ondanks complete respons van DCIS- Op MRI en contrast-versterkte mammografie is er in slechts een deel (gemiddeld 57%) van rest DCIS (ypTis) sprake van aankleuring. De definitie van pathologische complete respons is daarbij van invloed op de sensitiviteit en specificiteit van MRI.- Een mogelijk voordeel van contrast-versterkte mammografie in het combineren van evaluatie van aankleuring en calcificaties dient verder te worden onderzochtMijn dank aan de co-auteurs voor hun bijdrage: Kees de Mooij, Suzanne Gommers, Kristien Keymeulen, Marjolein Smidt en Thiemo van Nijnatten Lees het volledige artikel via deze link:

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Last week I had the opportunity to present two of our studies at the European Breast Cancer Conference in Barcelona. It was the first international conference I attended, and it was a very valuable learning experience.In the session "Breast conservation in high risk patients" I presented the results of our nationwide analysis on the complete response of DCIS to neoadjuvant systemic therapy in HER2+ invasive breast cancer patients. Patients with a DCIS component are less frequently treated with breast conserving surgery, despite a complete response of the DCIS component in 51.5% of the patients in our study population. Complete response was found to be associated with complete response of the invasive tumour, ER negativity of the invasive tumour and treatment with targeted therapy.The next step would be to assess whether imaging modalities can evaluate the response of the DCIS component during neoadjuvant therapy. On our poster we showed the results of our systematic review on this topic. Current imaging findings are insufficiently accurate to evaluate DCIS response.There is still a lot to look into on this subject.I would like to thank my research team for their help during the preparation for this conference. Marjolein Smidt, Thiemo van Nijnatten, Loes Kooreman, Eva Claassens, Kristien Keymeulen, Sabine Siesling, Maartje van Kats and Suzanne Gommers.#ebcc13

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Twee jaar bestuur van het Pélerìn arts-assistenten symposium zitten erop! In 2021 hebben we met de geldende maatregelen een mooie hybride versie georganiseerd. Dit jaar mochten we gelukkig iedereen weer in de originele setting verwelkomen. Als bestuur kijken we terug op een interessante en leerzame dag!Felicitaties aan alle genomineerden en natuurlijk aan de winnaars van de Pélerìn Wetenschapsprijs, Pitch prijs en Semi-arts prijs.Floor Pinckaers,Tom Wolswijk MD MScen Gabriela Pilz da Cunha.Daarnaast heel veel dank aan de rest van het bestuur voor de prettige en leuke samenwerking.Maud van Dinther,Michelle Bosman,Karlijn Demers,Lars Hillege,Tim Brokkenen Quirien Robbe.Pélerìn Arts Assistenten SymposiumMaastricht UMC+

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I am proud to announce that my first article has recently been published in the European Journal of Surgical Oncology. We demonstrated that, in our nationwide database of 20495 breast cancer patients treated with neoadjuvant systemic therapy (NST), 4.3% showed only residual DCIS (ypTis) in postoperative pathology. Consequently, the rate of pathological complete response after NST may be affected by ypTis when not excluded from the definition. This should be considered in future clinical decision making as well as future trials regarding response to NST.Many thanks to the co-authors and especially to my supervisors prof. dr. Marjolein Smidt and dr. Thiemo van Nijnatten.Kristien Keymeulen Loes Kooreman Sander van Kuijk Sabine Siesling

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