Observational studyAnnals of surgical oncology2021
Minimally Invasive Complete Response Assessment of the Breast After Neoadjuvant Systemic Therapy for Early Breast Cancer (MICRA trial): Interim Analysis of a Multicenter Observational Cohort Study.
Observational study in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Diagnostic accuracy of tumor bed biopsy for predicting pathological complete response in breast cancer patients achieving clinical complete response after neoadjuvant chemotherapy: a meta-analysis.Breast cancer research and treatment · 2026Pooled it
- The nodal positivity rate in breast pCR patients with initially, clinically node-negative breast cancer after neoadjuvant systemic therapy: A systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Clinical significance of residual microcalcifications after neoadjuvant chemotherapy: MRI response and the subtypes.NPJ breast cancer · 2026Article
- Deep learning-based radiomics does not improve residual cancer burden prediction post-chemotherapy in LIMA breast MRI trial.European radiology · 2026Article
- Emerging technologies for monitoring breast cancer response to neoadjuvant chemotherapy: a systematic scoping review.Breast (Edinburgh, Scotland) · 2026Review
- De-escalating breast and axillary surgery in breast cancer: evidence, controversies, and future directions.Frontiers in oncology · 2026Review
- Vacuum-Assisted Excision and Assessing Residual Tumor Burden in Patients With Breast Cancer Following Neoadjuvant Chemotherapy (A Pilot Study).International journal of breast cancer · 2026Article
- Progress in surgical management strategies after neoadjuvant therapy in breast cancer.Annals of medicine · 2025Review
- Image-guided biopsy of breast lesions-when to use what biopsy technique.Insights into imaging · 2025Article
- From the Desk of Editors: Omission of Surgery in Breast Cancer? Step Forward or Detour.Indian journal of surgical oncology · 2025Article
- Clinical applications of next-generation sequencing-based ctDNA analyses in breast cancer: defining treatment targets and dynamic changes during disease progression.Molecular oncology · 2025Review
- MRI-based artificial intelligence models for post-neoadjuvant surgery personalization in breast cancer: a narrative review of evidence from Western Pacific.The Lancet regional health. Western Pacific · 2025Review
- Breast cancer: pathogenesis and treatments.Signal transduction and targeted therapy · 2025Review
- Review
- Omission of breast surgery in exceptional responders after neoadjuvant chemotherapy-what are future possibilities?-a narrative review.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Review
- Who Are Suitable Patients for Omitting Breast Surgery as an Exceptional Responder in Selected Molecular Subtypes of Breast Cancer After Neoadjuvant Systemic Treatment?Medicina (Kaunas, Lithuania) · 2024Observational
- Diffusion-weighted imaging in addition to contrast-enhanced MRI in identifying complete response in HER2-positive breast cancer.European radiology · 2024Observational
- Deep-learning based discrimination of pathologic complete response using MRI in HER2-positive and triple-negative breast cancer.Scientific reports · 2024Article
- Utility of Axillary Staging in Older Patients with HER2-Positive Breast Cancer.Annals of surgical oncology · 2024Article
- Omission of Breast Surgery in Predicted Pathologic Complete Response after Neoadjuvant Systemic Therapy: A Multicenter, Single-Arm, Non-inferiority Trial.Journal of breast cancer · 2024Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe added value of surgery in breast cancer patients with pathological complete response (pCR) after neoadjuvant systemic therapy (NST) is uncertain. The accuracy of imaging identifying pCR for omission of surgery, however, is insufficient. We investigated the accuracy of ultrasound-guided biopsies identifying breast pCR (ypT0) after NST in patients with radiological partial (rPR) or complete response (rCR) on MRI.
methodsWe performed a multicenter, prospective single-arm study in three Dutch hospitals. Patients with T1-4(N0 or N +) breast cancer with MRI rPR and enhancement ≤ 2.0 cm or MRI rCR after NST were enrolled. Eight ultrasound-guided 14-G core biopsies were obtained in the operating room before surgery close to the marker placed centrally in the tumor area at diagnosis (no attempt was made to remove the marker), and compared with the surgical specimen of the breast. Primary outcome was the false-negative rate (FNR).
resultsBetween April 2016 and June 2019, 202 patients fulfilled eligibility criteria. Pre-surgical biopsies were obtained in 167 patients, of whom 136 had rCR and 31 had rPR on MRI. Forty-three (26%) tumors were hormone receptor (HR)-positive/HER2-negative, 64 (38%) were HER2-positive, and 60 (36%) were triple-negative. Eighty-nine patients had pCR (53%; 95% CI 45-61) and 78 had residual disease. Biopsies were false-negative in 29 (37%; 95% CI 27-49) of 78 patients. The multivariable associated with false-negative biopsies was rCR (FNR 47%; OR 9.81, 95% CI 1.72-55.89; p = 0.01); a trend was observed for HR-negative tumors (FNR 71% in HER2-positive and 55% in triple-negative tumors; OR 4.55, 95% CI 0.95-21.73; p = 0.058) and smaller pathological lesions (6 mm vs 15 mm; OR 0.93, 95% CI 0.87-1.00; p = 0.051).
conclusionThe MICRA trial showed that ultrasound-guided core biopsies are not accurate enough to identify breast pCR in patients with good response on MRI after NST. Therefore, breast surgery cannot safely be omitted relying on the results of core biopsies in these patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.