Preoperative or neoadjuvant chemotherapy is that which is administered after histological diagnosis and before surgical treatment. In randomized clinical trials it has been shown that survival when administering chemotherapy in breast cancer before or after surgery is identical. Preoperative treatment allows an increase in the rate of conservative surgery, measure tumor response and study new biological markers that help to understand the mechanisms that induce cell death and resistance to chemotherapy. However, it makes it necessary to study new prognostic factors and to assess the optimal surgical and radiotherapy approach after conservative surgery in a patient who has received chemotherapy.
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Preoperative or neoadjuvant systemic treatment refers to either the first postdiagnosis systemic treatment that a patient receives or indicates that additional subsequent therapy is intended. Randomized controlled clinical trials have shown that preoperative systemic treatment offers the same disease free survival and overall survival benefits as does adjuvant systemic treatment. Neoadjuvant therapy has been found to increase the breast-conserving surgery rate. This therapy also allows to evaluate the primary tumor response to chemotherapy. Additionally, on the basis of the biologic characteristics of a tumor and differences in the response to systemic treatment, primary systemic treatment should be regarded as a tool that can be used to individualize systemic treatment for patients with breast cancer. However, some issues remain to be resolved, such as the markers that should be assessed before this therapy, as well as the optimal surgical and radiotherapy treatment.
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Keywords
Breast cancer
Neoadjuvant treatment
Chemotherapy
Hormone therapy
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Key words
Breast cancer
Neoadjuvant treatment
Chemotherapy
Hormonal therapy
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