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The role of neoadjuvant chemotherapy for breast cancer treatment

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Abstract

Neoadjuvant chemotherapy has become popular, especially for patients with advanced breast cancer. The pros and cons of neoadjuvant chemotherapy for treating breast cancer patients are reviewed. The advantages of neoadjuvant chemotherapy are 1) overall survival and recurrence-free survival rate are the same as post-operative chemotherapy, 2) serves as anin vivo sensitivity test, 3) increases the rate of breast conserving therapy, 4) facilitates the study of cancer biology. On the other hand, the disadvantages of neoadjuvant chemotherapy are 1) it modifies the stage, 2) treatment delay of PD cases, 3) residual intraductal component may be left behind after breast conserving surgery, 4) there are some cases of over-treatment. Combination chemotherapy is one possible way to increase the pathological CR rate, although the optimal order and cycles have not been determined. To avoid residual cancer cells after breast conserving surgery, the shrinkage pattern should be evaluated by MRI. Core needle biopsy should be performed before neoadjuvant chemotherapy to avoid over-treatment. It is essential to develop more effective regimens and stratify patients based on predictive factors.

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Abbreviations

PD:

Progressive disease

CR:

Complete response

MRI:

Magnetic resonance image

pCR:

Pathological complete response

NSABP:

National Surgical Adjuvant Breast and Bowel Project

BCT:

Breast conserving treatment

ER:

Estrogen receptor

MDR:

Multiple drug resistance

RFS:

Recurrence-free survival

OS:

Overall survival

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Author information

Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Japan

    Tadashi Ikeda, Hiromitsu Jinno & Masaki Kitajima

  2. Keio Cancer Center, Japan

    Akira Matsui

  3. Tokyo Dental University, Japan

    Shigeru Masamura

Authors
  1. Tadashi Ikeda
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  2. Hiromitsu Jinno
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  3. Akira Matsui
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  4. Shigeru Masamura
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  5. Masaki Kitajima
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Corresponding author

Correspondence to Tadashi Ikeda.

Additional information

Reprint requests to Tadashi Ikeda, Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

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Ikeda, T., Jinno, H., Matsui, A. et al. The role of neoadjuvant chemotherapy for breast cancer treatment. Breast Cancer 9, 8–14 (2002). https://doi.org/10.1007/BF02967540

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  • DOI: https://doi.org/10.1007/BF02967540

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