{ "abstract": "Background: Optimal management of breast cancer (BC) patients with pathological complete response (pCR) after neoadjuvant therapy (NAT) remains debated. We performed a retrospective analysis to evaluate whether the extent of surgery influences survival outcomes in this patient population. Methods: Using the EUSOMA database, we retrospectively collected data of women with pCR after NAT, excluding those with BRCA1/2 mutations. The cohort was stratified by surgery type, i.e., breast-conserving surgery (BCS) or mastectomy. Relapse-free survival (RFS) and overall survival (OS) were compared using Cox regression. Results: Of 467 patients, 327 (70.0%) underwent BCS and 140 (30.0%) underwent mastectomy. Women treated with mastectomy were more likely to have multifocal tumors and advanced disease. After a median follow-up of 5.6 years, 7.3% of patients experienced BC recurrence. Axillary nodal involvement (cN+) and mastectomy were independently associated with recurrence, occurring in 11.4% of cN+ compared to 3.7% of cN0 patients (HR 3.02; 95% CI: 1.40–6.51; p = 0.005) and in 12.5% of mastectomy vs. 5.2% of BCS patients (HR 2.08; 95% CI: 1.05–4.11; p 0.035). cN+ patients also showed significantly higher mortality rates (9.4% vs. 1.6% of cN0; HR 6.16; 95%CI: 2.09–18.17; p= 0.001). However, surgery type did not impact OS. Conclusion: In this cohort of BC patients with pCR after NAT, BCS was not associated with a higher risk of recurrence compared with mastectomy. Baseline nodal involvement independently predicted recurrence and mortality; however, the type of surgery did not impact OS. These findings support BCS as a safe treatment option for this patient population.", "abstract_shown": true, "affiliations": [ "Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy", "Humanitas-Istituto Clinico Catanese, Misterbianco, 95045 Catania, Italy", "Department of Biomedical Sciences, Humanitas University, Rozzano, 20089 Milan, Italy", "Breast Unit, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy", "European Society of Breast Cancer Specialists (EUSOMA), 50019 Florence, Italy", "CPO Piemonte, 10123 Turin, Italy", "Radiation Oncology Section, Department of Medicine and Surgery, University of Perugia, 06156 Perugia, Italy", "Perugia General Hospital, Sant’Andrea delle Fratte, 06156 Perugia, Italy", "Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK", "Academic Unit for Translational Medical Sciences, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Nottingham NG7 2UH, UK", "Akershus University Hospital, 1478 Nordbyhagen, Norway", "Breast Surgical Oncology, Clinica Universidad de Navarra, Cancer Center Universidad de Navarra, 28027 Madrid, Spain", "Department of Pathology, IRCCS Policilnico S. Orsola, University of Bologna, 40138 Bologna, Italy", "Lega Italiana per la Lotta Contro i Tumori (LILT) Milano Monza Brianza, 20133 Milan, Italy", "Department of Oncology and Radiotherapy, Medical University of Gdańsk, 80-211 Gdańsk, Poland", "Breast Unit, University Clinical Center, 80-952 Gdańsk, Poland", "Multidisciplinary Oncologic Center, Antwerp University Hospital, 2650 Edegem, Belgium", "Department of Oncology and Hemato-Oncology, University of Milano, 20122 Milan, Italy", "Division of New Drugs and Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, 20141 Milan, Italy" ], "article_type": null, "arxiv": null, "author_total": 17, "authors": [ { "affs": [ 0, 1 ], "name": "Federica Martorana" }, { "affs": [ 2, 3 ], "name": "Damiano Gentile", "orcid": "0000-0002-8861-5223" }, { "affs": [ 4 ], "name": "Mariano Tomatis" }, { "affs": [ 4, 5 ], "name": "Antonio Ponti" }, { "affs": [ 4 ], "name": "Lorenza Marotti" }, { "affs": [ 6, 7 ], "name": "Cynthia Aristei", "orcid": "0000-0002-9749-649X" }, { "affs": [ 8 ], "name": "Nicolò Matteo Luca Battisti" }, { "affs": [ 9 ], "name": "Kwok Leung Cheung", "orcid": "0000-0003-2973-0755" }, { "affs": [ 10 ], "name": "Olaf Johan Hartmann", "orcid": "0000-0002-3718-6342" }, { "affs": [ 11 ], "name": "Isabel T. Rubio" }, { "affs": [ 12 ], "name": "Donatella Santini", "orcid": "0000-0002-1692-6348" }, { "affs": [ 13 ], "name": "Francesco Sardanelli" }, { "affs": [ 14, 15 ], "name": "Elzbieta Senkus", "orcid": "0000-0001-6855-397X" }, { "affs": [ 16 ], "name": "Peter van Dam", "orcid": "0000-0002-9184-7703" }, { "affs": [ 17, 18 ], "name": "Giuseppe Curigliano", "orcid": "0000-0003-1781-2518" }, { "affs": [ 1, 2 ], "name": "Giuseppe Catanuto" }, { "name": "on behalf of the EUSOMA Working" } ], "bibtex": "https://research.draconitic.com/paper/ekc9gj4fwwc46.bib", "cited_by": 0, "doi": "10.3390/cancers18213536", "fulltext_url": null, "id": "ekc9gj4fwwc46", "issns": [ "2072-6694" ], "landing_url": "https://www.mdpi.com/2072-6694/18/21/3536", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [], "openalex": null, "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-11-03", "publisher": "MDPI AG", "ris": "https://research.draconitic.com/paper/ekc9gj4fwwc46.ris", "sources": [ { "first_seen": "2026-11-04T00:26:38Z", "native_id": "10.3390/cancers18213536", "source": "crossref", "url": "https://www.mdpi.com/2072-6694/18/21/3536" } ], "subjects": [ { "field": "medicine", "origin": "issn:2072-6694", "subfield": "oncology" } ], "title": "Survival and Extent of Breast Surgery in Patients with Complete Response After Neoadjuvant Therapy: A Retrospective Analysis from the EUSOMA Database", "title_text": "Survival and Extent of Breast Surgery in Patients with Complete Response After Neoadjuvant Therapy: A Retrospective Analysis from the EUSOMA Database", "type": "peer-reviewed", "updated_at": "2026-11-05T00:21:09Z", "url": "https://research.draconitic.com/paper/ekc9gj4fwwc46", "venue": "Cancers", "versions": [] }