Breast Cancer

, 8:23

The evidence-based use of induction chemotherapy in Breast Cancer

  • Justin Stebbing
  • Andrew Gaya
Review Article

DOI: 10.1007/BF02967475

Cite this article as:
Stebbing, J. & Gaya, A. Breast Cancer (2001) 8: 23. doi:10.1007/BF02967475

Abstract

The use of induction chemotherapy, also known as pre-operative or neoadjuvant chemotherapy has been studied in a number of randomised trials. Response rates are generally high, ranging from 70-90%, which allows for the downstaging of primary tumours and breast conservation surgery. Conserving surgery as opposed to mastectomy in this setting appears to be safe, effective and improves quality of life, although there is a suggestion of a small increase in local recurrence rate. Data from the randomised trials presented in this review shows that the use of induction chemotherapy neither prolongs nor decreases overall or disease free survival when compared with the same chemotherapy given in an adjuvant setting. There is a direct correlation between response of a primary breast tumour to induction chemotherapy and patient outcome, probably because this approximates the effect of induction chemotherapy on micrometastases which are present at presentation in many patients with apparently localised primary breast cancers. A pathological complete response after surgery is an excellent predictor of long term outcome, and is more likely to be seen in smaller tumours. Induction chemotherapy can be used as anin vivo measure of tumour response to treatment. This allows a further option of switching cytotoxic drugs in apparently resistant tumours.

Key words

Induction Neo-adjuvant Pre-operative chemotherapy 

Copyright information

© The Japanese Breast Cancer Society 2001

Authors and Affiliations

  • Justin Stebbing
    • 1
  • Andrew Gaya
    • 2
  1. 1.Specialist Registrar in Medical OncologyThe Royal Marsden HospitalUK
  2. 2.Specialist Registrar in Clinical OncologyThe Royal Postgraduate Medical School, The Hammersmith HospitalUK
  3. 3.Specialist Registrar in Medical OncologyThe Royal Marsden HospitalLondonUK

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