Extensive DCIS and microcalcifications in patients with breast cancer reaching pCR after NAC

Tanja Gagliardi, MD; Ashutosh Nerurka, MD; Marios Tasoulis MD, PhD, FEBS, FRCS; and Nicolò Battisti, MD; members of the clinical radiology, pathology, medical oncology and breast surgery teams at The Royal Marsden NHS Foundation Trust, London, UK, discuss the findings of a study assessing the impact of microcalcifications in patients with breast cancer achieving a pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). 26 patients with an extensive in situ component and microcalcifications who achieved a pCR of their invasive disease following NAC were retrospectively reviewed. Three patients had loco-regional recurrence, all of whom had persistent DCIS and microcalcifications. Analyses showed that microcalcifications post-NAC were not associated with tumor characteristics, did not reflect treatment responses, and were not a marker for persistent ductal carcinoma in situ. The study raises questions regarding the impact of DCIS on disease recurrence and loco-regional management of these patients. Larger studies are needed to further understand these trends. This interview took place during the 17th St. Gallen International Breast Cancer Conference.