National Breast Cancer Surgery Snapshot Study: Breast Cancer Surgery after Neoadjuvant Systemic Therapy in Primary Breast Cancer (MANS Study)
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: The use of neoadjuvant systemic therapy (NST) in primary breast cancer has increased worldwide. This study provides real-time data of the reasons and variation in NST, conversion rate of mastectomy to BCS and conversion rate of ALND to radiation or omission of axillary treatment. METHODS: This is a Breast Cancer Surgery Snapshot study, multicenter prospective cross-sectional study in 70 breast cancer hospitals in the Netherlands. For 2 months the reason for NST is registered with patient- and tumor characteristics. The expectation of the surgical procedure in breast and axilla before and after NST is noted and the actual surgical outcome after NST is registered. RESULTS: Four hundred sixty seven patients receiving NST were registered. The 3 main reasons for NST were in 26% axillary down-staging, 25% a triple negative (TN) tumor and 25% HER2+. Before NST, 219 patients (47%) were eligible for BCS. In 210 patients (45%) initially assigned to receive a mastectomy, 99 patients (47%) underwent BCS. Triple negativity had the highest conversion rate with 68%. Of all mastectomy patients, 30% showed a pCR of the breast. Axillary conversion from ALND to axillary sparing surgery was achieved in 87% cN+ patients. CONCLUSION: In the Netherlands the main reasons for NST were subtype (triple negative, HER2+) and axillary down staging. Additional reasons for NST focused more on down staging to convert to BCS and improve cosmetic outcomes. Real time data showed that NST lead to very high conversion rates from mastectomy to BCS as well as high rates of omission of ALND after NST.
Source: Clinical Breast Cancer
Authors: Gaelle Kramer, José Volders, Femke den Haring, Roza Opperman, Pauline Spronk, Petrousjka van den Tol, Marie-Jeanne Vrancken Peeters, T. Lans, M.B.E. Menke-Pluijmers, M. Vounckx, H. Schotte, A.N. Kimmings, F.G.A.M. Grosfeld, A.M. Zeilemaker, L.F.C. Dols, C.M.L. Peters, A.H. Baan, S. van der Velde, G.M.P. Diepenhorst, C.E.S. Hoogstins, H. van Cruijsen, K. Kui, T. Frakking, S.A.H. Jeuriens - van de Ven, A. Baan, S. Vijfhuize, L.J.A. Strobbe, S.Z. Wennmacker, R.J. Schipper, A.C.H.M. Jongen, H. Torrenga, M.J.P.M. Govaert, B.M.D. Lemaire, MJM Kuijpers, P. Jansen, B. Strijbos, M.E.E. Bröker, S. Wooldrik, E.J.V. Nieuwenhoven, A. Jilesen, E. Linthorst, A. van Beurden, M.E. Straver, A. Marinelli, I. Jannink, J.W.S. Merkus, M.W.H. Leenders, C. van 't Hullenaar, G. Tetteroo, M. Kop, W.J. Vles, J. de Kort, A.B. Francken, H.A. Schuttevaer, M. Bessems, L. van Zutphen, L. Levert, A. Wijnen, C. Verberne, C.M.E. Contant, W. van Linden, M.L. Smidt, S.R. de Wild, B. Frietman, A.J.G. Maaskant, W.A.R. Zwaans, W.N. Welvaart, E. Goudzwaard, E.J.P. Schoenmaeckers, M.J. Brinckman, A.E. Dassen, I. Meijer, G.A. Gooiker, S.A. Gooijer, M.S. Schlooz-Vries, M.J.G. Andriessen, L.H. Mammatas, E.B. van Druten, R.R.J.P. van Eekeren, S.W.J. de Gier, N.J. Harlaar, L. Stengs, M.H. Raber, G.E. Bouwhuis, A.C. Brink, K.M.M. Luttikholt, L. Posma, K.M. Blaauwendraat, M.A. Vlek, R. den Toom, A.P. Schoute van der Velde, E.M. Aalderink, E.E.M. Schepers, E.D. Heijmans, A. Doeksen, B.A.M. Jansen, J.A. van Essen, I. Mulder, E.J.C. Vriens, E. Westerduin, I. Kappers, E. Talman, L.H.M. Smit, M.C. Richir, F. Aarts, E.S. van Loo, S. Brookman-Mozes, S. Muller, S.F. Hardon, M.L. Hoven-Gondrie, C. Schormans, R. Knulst, F. Grimme, N. Vermulst, E.L. Postma, Tiel E. van Dessel, J. van Bastelaar, M. Spiekerman van Weezelenburg
Institutions: The Netherlands Cancer Institute, Diakonessenhuis hospital, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Alrijne Ziekenhuis, Medisch Centrum Leeuwarden, Admiraal De Ruyter Ziekenhuis, Albert Schweitzer Ziekenhuis, Alexander Monro Ziekenhuis, Amphia Ziekenhuis, Ziekenhuis Amstelland, Flevoziekenhuis, Antonius Ziekenhuis, Rivas Zorggroep, Beatrixziekenhuis, Ziekenhuis Bernhoven, Bravis Ziekenhuis, Canisius-Wilhelmina Ziekenhuis, Catharina Ziekenhuis, Deventer Ziekenhuis, Dijklander Ziekenhuis, Elkerliek Ziekenhuis, Elisabeth-TweeSteden Ziekenhuis, Sint Franciscus Gasthuis, Gelre Hospitals, Groene Hart Ziekenhuis, Medisch Centrum Haaglanden, Stichting Haaglanden Medisch Centrum, Haga Hospital, IJsselland Ziekenhuis, Ikazia Ziekenhuis, Isala, Jeroen Bosch Ziekenhuis, Lange Land Ziekenhuis, Laurentius Ziekenhuis, Maasstad Ziekenhuis, Maastricht University Medical Centre, Radboud University Medical Center, Máxima Medisch Centrum, Maastricht University, Meander Medisch Centrum, Medisch Spectrum Twente, Noordwest Ziekenhuisgroep, Radboud University Nijmegen, Reinier de Graaf Hospital, Rijnstate Hospital, Rode Kruis Ziekenhuis, Streekziekenhuis Koningin Beatrix, Slingeland Ziekenhuis, Spaarne Ziekenhuis, Spaarne Gasthuis, St. Anna Ziekenhuis, St. Antonius Ziekenhuis, St.Jans Gasthuis Weert, Tergooi, Tjongerschans, Treant Zorggroep, University Medical Center Utrecht, VieCuri Medisch Centrum, Zaans Medisch Centrum, Ziekenhuis Gelderse Vallei, Ziekenhuis Groep Twente, Ziekenhuis Nij Smellinghe, Ziekenhuis Rivierenland, ZorgSaam, Zuyderland Medisch Centrum
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,470
OpenAlex ID: W4416400160