Evidence map›Paper›PMID 41964157›Full record

ArticleInternational journal of cancer2026

The Predictive Value of the Tumor-Stroma Ratio for Neoadjuvant Endocrine Therapy in Hormone Receptor-Positive Breast Cancer.

Layla Andour, Sophie C Hagenaars, Anne Florine de Groot, Elly M M Krol-Warmerdam, Judith R Kroep, Hans Marten Hazelbag, Gerrit-Jan Liefers, Marieke E Straver, Wilma E Mesker

Abstract read
In one paragraph

Article in International journal of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Layla AndourDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0002-0073-9601
Sophie C HagenaarsDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0002-9121-1975
Anne Florine de GrootDepartment of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands.ORCID https://orcid.org/0000-0001-7612-2918
Elly M M Krol-WarmerdamDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Judith R KroepDepartment of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands.
Hans Marten HazelbagDepartment of Pathology, Haaglanden Medical Center, The Hague, the Netherlands.
Gerrit-Jan LiefersDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
Marieke E StraverDepartment of Surgery, Medical Center Haaglanden, The Hague, the Netherlands.
Wilma E MeskerDepartment of Surgery, Leiden University Medical Center, Leiden, the Netherlands.

Funding

Bollenstreekfonds, Lisse
6 · The paper itself

Abstract

Approximately 75% of breast cancers are hormone receptor-positive (HR+). Endocrine therapy may be administered to improve survival. Neoadjuvant therapy may enable breast- and axilla-conserving surgery, but identifying who will benefit remains challenging. This study evaluates the predictive value of the tumor-stroma ratio (TSR) for response to neoadjuvant endocrine therapy (NET) and examines the accuracy of MRI in predicting (near) pathological complete response (pCR). Women diagnosed between 2014 and 2024 with invasive HR+, human epidermal growth factor 2-negative breast cancer who received NET in two Dutch hospitals were included. A total of 208 women (215 tumors) were included, of whom 81 (37.7%) had a stroma-low tumor and 134 (62.3%) stroma-high. Almost 1 out of 4 stroma-low cases achieved (near) pCR after NET. In both univariable (OR 2.85, 95% CI 1.32-6.15, p = 0.008) and multivariable analysis (OR 3.70, 95% CI 1.54-8.90, p = 0.003), stroma-low tumors showed an increased likelihood of achieving (near) pCR compared to stroma-high tumors. In node-positive patients (n = 117), univariable analysis presented higher odds of pCR in the axilla after NET in the stroma-low group (OR 4.41, 95% CI 1.08-18.08, p = 0.039), although this was not significant in multivariable analysis (p = 0.060). The MRI correctly reported (near) pCR in 12 (75%) stroma-low cases and 8 (35%) stroma-high. Stroma-low patients significantly more often achieved (near) pCR of the tumor and axilla after NET compared to stroma-high patients. The accuracy of MRI to predict (near) pCR was higher in the stroma-low group compared to the stroma-high group.

Indexed as

Antineoplastic Agents, HormonalBreast NeoplasmsNeoadjuvant TherapyStromal CellsAdultAgedErb-b2 Receptor Tyrosine KinasesFemaleHumansMagnetic Resonance ImagingMiddle AgedPathologic Complete ResponsePredictive Value of TestsPrognosisReceptors, EstrogenReceptors, ProgesteroneAntineoplastic Agents, HormonalERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, Progesteronebreast cancerendocrine therapymagnetic imaging resonanceneoadjuvant systemic therapytumor‐stroma ratio

Identifiers

PMID41964157
PMCPMC13284621

What OpenQuestion holds

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Registered trials

None linked

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.