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

Eur J Surg Oncol. 2025 Jan;51(1):108781. doi: 10.1016/j.ejso.2024.108781. Epub 2024 Oct 22.

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.

Keywords: Pathological complete response; Residual microcalcifications.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • Calcinosis* / diagnostic imaging
  • Calcinosis* / pathology
  • Calcinosis* / surgery
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Mammography*
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Grading
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Survival Rate