Neoadjuvant therapy in the treatment of breast cancer

Surg Oncol Clin N Am. 2014 Jul;23(3):505-23. doi: 10.1016/j.soc.2014.03.006. Epub 2014 Apr 24.

Abstract

Neoadjuvant systemic therapy in breast cancer treatment was initially utilized for inoperable disease. However, several randomized prospective studies have demonstrated comparable survival with adjuvant chemotherapy in early-stage, operable breast cancer while also decreasing tumor size facilitating breast conservation without significant increases in local recurrence. Response to therapy can predict outcome, with improved survival associated with pathologic complete response (pCR). Triple negative and HER2-positive subtypes show increased pCR rates. A multidisciplinary approach is necessary with neoadjuvant treatment. This can improve rates of breast conservation, provide insights into tumor biology and predict patient outcomes.

Keywords: Breast cancer; Neoadjuvant chemotherapy; Pathologic complete response; Preoperative chemotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Female
  • Genes, erbB-2 / genetics
  • Humans
  • Mastectomy, Segmental
  • Neoadjuvant Therapy*
  • Prognosis
  • Taxoids / administration & dosage

Substances

  • Antineoplastic Agents
  • Taxoids