, Volume 16, Issue 4, pp 1063-1064
Date: 10 Feb 2009

Neoadjuvant Chemotherapy for Breast Cancer: Does Pretreatment Axillary Nodal Staging Improve Decision Making?

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To the Editor

Preoperative or neoadjuvant chemotherapy has been standard clinical practice in locally advanced breast cancer. This approach offers also the potential of tumor downstaging, allowing breast-conserving surgery (BCS) for women with large tumors at diagnosis.1 BCS is the preferred approach when certain criteria are met, excluding women with familial susceptibility to breast cancer and BRCA1- or BRCA2-positive testing.25 However, there are several limitations, including incomplete primary tumor resection with positive resection margins after neoadjuvant chemotherapy followed by BCS. In the research arena, neoadjuvant therapeutic approach offers the major advantage of testing tumor response. Pathological partial or complete tumor reduction after experimental treatment with new targeted agents plus chemotherapy can be assessed in substantially shorter time period after systemic treatment rather than the anticipated 5 years to measure response with clinical endpoints such as dis