Current and future role of neoadjuvant therapy for breast cancer

  • Neoadjuvant systemic chemotherapy is a possible therapeutic approach for the treatment of locally advanced operable, primarily non-operable or inflammatory breast cancer. Neoadjuvant systemic chemotherapy is an option for breast cancer patients who would require adjuvant chemotherapy otherwise based on clinical and histological examination and imaging. The use of neoadjuvant systemic therapy in operable breast cancer is currently increasing because of its advantages that include higher rates of breast conserving surgery and the possibility of measuring early in-vivo response to systemic treatment. The timing of axillary sentinel lymph node diagnosis (i.e. before or after neoadjuvant chemotherapy) is critical in that it may influence the likelihood of axillary preservation. It is not yet clear if neoadjuvant therapy might improve outcomes in certain subgroups of breast cancer patients. Neoadjuvant treatment modalities require a close collaboration between oncology professionals, including surgeons, gynecologists, medical oncologists, radiation oncologists, radiologists and pathologists. The most important parameter for treatment success and improved overall survival is the achievement of a pathologic complete response (pCR), although the role of pCR in patients with luminal A like tumours might be less informative. Identification of patient subgroups with high pCR rates may allow less invasive surgical or radiological interventions. Patients not achieving a pCR may be candidates for postoperative clinical trials exploring novel systemic treatments.

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Author:Michael UntchORCiDGND, Gottfried E. KonecnyORCiD, Stefan PaepkeORCiDGND, Gunter von MinckwitzORCiDGND
Parent Title (English):The Breast
Place of publication:Amsterdam
Document Type:Article
Date of Publication (online):2014/07/14
Date of first Publication:2014/07/14
Publishing Institution:Universit├Ątsbibliothek Johann Christian Senckenberg
Release Date:2023/10/12
Tag:Breast cancer; Breast conserving surgery; Molecular subtypes; Neoadjuvant systemic therapy; Pathologic complete response
Page Number:12
First Page:526
Last Page:537
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International