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The Impact of Neoadjuvant Chemotherapy on Local-Regional Treatment of Breast Cancer

  • Local-Regional Evaluation and Therapy (KK Hunt, Section Editor)
  • Published:
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Abstract

Neoadjuvant chemotherapy (NC) is the standard of care for patients with locally advanced breast cancer and a reasonable alternative to adjuvant chemotherapy for those with large operable disease. Potential clinical advantages with neoadjuvant chemotherapy include the conversion of some patients requiring mastectomy to candidates for breast conserving surgery, the potential for down-staging axillary nodes, and thus, reducing the extent of axillary surgery and the ability to correlate clinical and pathologic response to neoadjuvant chemotherapy with improved long-term outcomes. Several unique local-regional therapy issues have emerged in patients who are candidates for NC. These relate to the appropriate surgical management of primary breast tumors and axillary lymph nodes as well as the optimal use of radiotherapy in this setting. Additional important issues include the accurate assessment of the location and extent of the primary breast tumor and axillary nodes before, during and after NC since this affects the execution and outcomes of local-regional therapy. In the years to come, the development of more active neoadjuvant chemotherapy regimens and novel molecular and imaging techniques, will undoubtedly lead to further individualization of breast cancer local-regional management.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Fisher B, Redmond C, Poisson R. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1989;320:822–8.

    Article  PubMed  CAS  Google Scholar 

  2. Veronesi U, Saccozzi R, Del Vecchio M, et al. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981;305:6–11.

    Article  PubMed  CAS  Google Scholar 

  3. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.

    Article  PubMed  Google Scholar 

  4. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.

    Article  PubMed  Google Scholar 

  5. Early Breast Cancer Trialists' Collaborative Group. systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1992;339:71–85.

    Google Scholar 

  6. Early Breast Cancer Trialists' Collaborative Group. Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1998;352:930–42.

    Article  Google Scholar 

  7. Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: 9-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr. 2001;96–102.

  8. van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19:4224–37.

    PubMed  Google Scholar 

  9. Gianni L, Baselga J, Eirmann W, et al. European Cooperative Trial in Operable Breast Cancer (ECTO): improved freedom from progression (FFP) from adding paclitaxel (T) to doxorubicin (A) followed by cyclophosphamide methotrexate and fluorouracil (CMF). J Clin Oncol. 2005;23:7s (abstract 513).

    Article  Google Scholar 

  10. Bear HD, Anderson S, Brown A, et al. The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2003;21:4165–74.

    Article  PubMed  CAS  Google Scholar 

  11. Gianni L, Baselga J, Eiermann W, et al. First report of the European Cooperative Trial in operable breast cancer (ECTO): effect of primary systemic therapy. Proc Am Soc Clin Oncol. 2002;21:34a (abstract 132).

    Google Scholar 

  12. El-Tamer M, Axiotis C, Kim E, et al. Accurate prediction of the amount of in situ tumor in palpable breast cancers by core needle biopsy: implications for neoadjuvant therapy. Ann Surg Oncol. 1999;6:461–6.

    Article  PubMed  CAS  Google Scholar 

  13. Kaneko S, Gerasimova T, Butler WM, et al. The use of FISH on breast core needle samples for the presurgical assessment of HER-2 oncogene status. Exp Mol Pathol. 2002;73:61–6.

    Article  PubMed  CAS  Google Scholar 

  14. Taucher S, Rudas M, Gnant M, et al. Sequential steroid hormone receptor measurements in primary breast cancer with and without intervening primary chemotherapy. Endocr Relat Canc. 2003;10:91–8.

    Article  CAS  Google Scholar 

  15. Herrada J, Iyer RB, Atkinson EN, et al. Relative value of physical examination, mammography, and breast sonography in evaluating the size of the primary tumor and regional lymph node metastases in women receiving neoadjuvant chemotherapy for locally advanced breast carcinoma. Clin Cancer Res. 1997;3:1565–9.

    PubMed  CAS  Google Scholar 

  16. Kuerer HM, Singletary SE, Buzdar AU, et al. Surgical conservation planning after neoadjuvant chemotherapy for stage II and operable stage III breast carcinoma. Am J Surg. 2001;182:601–8.

    Article  PubMed  CAS  Google Scholar 

  17. Esserman L, Hylton N, Yassa L, et al. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999;17:110–9.

    PubMed  CAS  Google Scholar 

  18. Stoutjesdijk MJ, Boetes C, Jager GJ, et al. Magnetic resonance imaging and mammography in women with a hereditary risk of breast cancer. J Natl Canc Inst. 2001;93:1095–102.

    Article  CAS  Google Scholar 

  19. Kriege M, Brekelmans CT, Boetes C, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 2004;351:427–37.

    Article  PubMed  CAS  Google Scholar 

  20. Esserman L, Kaplan E, Partridge S, et al. MRI phenotype is associated with response to doxorubicin and cyclophosphamide neoadjuvant chemotherapy in stage III breast cancer. Ann Surg Oncol. 2001;8:549–59.

    Article  PubMed  CAS  Google Scholar 

  21. Nakamura S, Kenjo H, Nishio T, et al. Efficacy of 3D-MR mammography for breast conserving surgery after neoadjuvant chemotherapy. Breast Canc. 2002;9:15–9.

    Article  Google Scholar 

  22. Nakamura S, Kenjo H, Nishio T, et al. 3D-MR mammography-guided breast conserving surgery after neoadjuvant chemotherapy: clinical results and future perspectives with reference to FDG-PET. Breast Canc. 2001;8:351–4.

    Article  CAS  Google Scholar 

  23. Morris EA. Review of breast MRI: indications and limitations. Semin Roentgenol. 2001;36:226–37.

    Article  PubMed  CAS  Google Scholar 

  24. Baron LF, Baron PL, Ackerman SJ, et al. Sonographically guided clip placement facilitates localization of breast cancer after neoadjuvant chemotherapy. Am J Roentgenol. 2000;174:539–40.

    Article  CAS  Google Scholar 

  25. Alonso-Bartolome P, Ortega Garcia E, Garijo Ayensa F, et al. Utility of the tumor bed marker in patients with breast cancer receiving induction chemotherapy. Acta Radiol. 2002;43:29–33.

    Article  PubMed  CAS  Google Scholar 

  26. Danforth Jr DN, Aloj L, Carrasquillo JA, et al. The role of 18 F-FDG-PET in the local/regional evaluation of women with breast cancer. Breast Canc Res Treat. 2002;75:135–46.

    Article  CAS  Google Scholar 

  27. Mankoff DA, Dunnwald LK, Gralow JR, et al. Monitoring the response of patients with locally advanced breast carcinoma to neoadjuvant chemotherapy using [technetium 99 m]-sestamibi scintimammography. Cancer. 1999;85:2410–23.

    Article  PubMed  CAS  Google Scholar 

  28. Akashi-Tanaka S, Fukutomi T, Sato N, et al. The role of computed tomography in the selection of breast cancer treatment. Breast Canc. 2003;10:198–203.

    Article  Google Scholar 

  29. Oruwari JU, Chung MA, Koelliker S, et al. Axillary staging using ultrasound-guided fine needle aspiration biopsy in locally advanced breast cancer. Am J Surg. 2002;184:307–9.

    Article  PubMed  Google Scholar 

  30. Krishnamurthy S, Sneige N, Bedi DG, et al. Role of ultrasound-guided fine-needle aspiration of indeterminate and suspicious axillary lymph nodes in the initial staging of breast carcinoma. Cancer. 2002;95:982–8.

    Article  PubMed  Google Scholar 

  31. Bedrosian I, Reynolds C, Mick R, et al. Accuracy of sentinel lymph node biopsy in patients with large primary breast tumors. Cancer. 2000;88:2540–5.

    Article  PubMed  CAS  Google Scholar 

  32. Schrenk P, Hochreiner G, Fridrik M, et al. Sentinel node biopsy performed before preoperative chemotherapy for axillary lymph node staging in breast cancer. Breast J. 2003;9:282–7.

    Article  PubMed  Google Scholar 

  33. Sabel MS, Schott AF, Kleer CG, et al. Sentinel node biopsy prior to neoadjuvant chemotherapy. Am J Surg. 2003;186:102–5.

    Article  PubMed  Google Scholar 

  34. Ollila DW, Neuman HB, Sartor C, et al. Lymphatic mapping and sentinel lymphadenectomy prior to neoadjuvant chemotherapy in patients with large breast cancers. Am J Surg. 2005;190:371–5.

    Article  PubMed  Google Scholar 

  35. Chung MH, Ye W, Giuliano AE. Role for sentinel lymph node dissection in the management of large (> or = 5 cm) invasive breast cancer. Ann Surg Oncol. 2001;8:688–92.

    PubMed  CAS  Google Scholar 

  36. Krag DN, Anderson SJ, Julian TB, et al. Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomized phase III trial. Lancet Oncol. 2007;8:881–8.

    Article  PubMed  CAS  Google Scholar 

  37. Veronesi U, Paganelli G, Viale G, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546–53.

    Article  PubMed  Google Scholar 

  38. Tafra L, Lannin DR, Swanson MS, et al. Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg. 2001;233:51–9.

    Article  PubMed  CAS  Google Scholar 

  39. McMasters KM, Tuttle TM, Carlson DJ, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol. 2000;18:2560–6.

    PubMed  CAS  Google Scholar 

  40. Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicenter randomized trial with a 124-month median follow-up. Institut Bergonie Bordeaux Groupe Sein (IBBGS). Ann Oncol. 1999;10:47–52.

    Article  PubMed  CAS  Google Scholar 

  41. Bonadonna G, Valagussa P, Brambilla C, et al. Primary chemotherapy in operable breast cancer: 8-year experience at the Milan Cancer Institute. J Clin Oncol. 1998;16:93–100.

    PubMed  CAS  Google Scholar 

  42. Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15:2483–93.

    PubMed  CAS  Google Scholar 

  43. Sinn HP, Schmid H, Junkermann H. et al [Histologic regression of breast cancer after primary (neoadjuvant) chemotherapy]. Geburtshilfe Frauenheilkd. 1994;54:552–8.

    Article  PubMed  CAS  Google Scholar 

  44. Cocquyt VF, Blondeel PN, Depypere HT, et al. Different responses to preoperative chemotherapy for invasive lobular and invasive ductal breast carcinoma. Eur J Surg Oncol. 2003;29:361–7.

    Article  PubMed  CAS  Google Scholar 

  45. Cristofanilli M, Gonzalez-Angulo A, Sneige N, et al. Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol. 2005;23:41–8.

    Article  PubMed  Google Scholar 

  46. Julian TB, Anderson S, Fourchotte V, et al. Is invasive lobular breast cancer a prognostic factor for neoadjuvant chemotherapy response and long term outcomes? Breast Canc Res Treat. 2006;100:S146 (abstract 3065).

    Google Scholar 

  47. Newman LA, Buzdar AU, Singletary SE, et al. A prospective trial of preoperative chemotherapy in resectable breast cancer: predictors of breast-conservation therapy feasibility. Ann Surg Oncol. 2002;9:228–34.

    Article  PubMed  Google Scholar 

  48. Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant vs adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Canc Inst. 2005;97:188–94.

    Article  Google Scholar 

  49. Mieog JS, van der Hage JA, van de Velde CJ. Preoperative chemotherapy for women with operable breast cancer. Cochrane Database Syst Rev. 2007;CD005002.

  50. McMasters KM, Hunt KK. Neoadjuvant chemotherapy, locally advanced breast cancer, and quality of life. J Clin Oncol. 1999;17:441–4.

    PubMed  CAS  Google Scholar 

  51. Styblo TM, Lewis MM, Carlson GW, et al. Immediate breast reconstruction for stage III breast cancer using transverse rectus abdominis musculocutaneous (TRAM) flap. Ann Surg Oncol. 1996;3:375–80.

    Article  PubMed  CAS  Google Scholar 

  52. Deutsch MF, Smith M, Wang B, et al. Immediate breast reconstruction with the TRAM flap after neoadjuvant therapy. Ann Plast Surg. 1999;42:240–4.

    Article  PubMed  CAS  Google Scholar 

  53. Newman LA, Kuerer HM, Hunt KK, et al. Feasibility of immediate breast reconstruction for locally advanced breast cancer. Ann Surg Oncol. 1999;6:671–5.

    Article  PubMed  CAS  Google Scholar 

  54. Sultan MR, Smith ML, Estabrook A, et al. Immediate breast reconstruction in patients with locally advanced disease. Ann Plast Surg. 1997;38:345–9. discussion 350–1.

    Article  PubMed  CAS  Google Scholar 

  55. Hunt KK, Baldwin BJ, Strom EA, et al. Feasibility of postmastectomy radiation therapy after TRAM flap breast reconstruction. Ann Surg Oncol. 1997;4:377–84.

    Article  PubMed  CAS  Google Scholar 

  56. Slavin SA, Love SM, Goldwyn RM. Recurrent breast cancer following immediate reconstruction with myocutaneous flaps. Plast Reconstr Surg. 1994;93:1191–204. discussion 1205–7.

    Article  PubMed  CAS  Google Scholar 

  57. Motwani SB, Strom EA, Schechter NR, et al. The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66:76–82.

    Article  PubMed  Google Scholar 

  58. McKeown DJ, Hogg FJ, Brown IM, et al. The timing of autologous latissimus dorsi breast reconstruction and effect of radiotherapy on outcome. J Plast Reconstr Aesthet Surg. 2008;62(4)488–93.

    Google Scholar 

  59. Kronowitz SJ. Immediate vs delayed reconstruction. Clin Plast Surg. 2007;34:39–50 (abstract vi).

    Article  PubMed  Google Scholar 

  60. O'Hea BJ, Hill AD, El-Shirbiny AM, et al. Sentinel lymph node biopsy in breast cancer: initial experience at Memorial Sloan-Kettering Cancer Center. J Am Coll Surg. 1998;186:423–7.

    Article  PubMed  Google Scholar 

  61. Krag DN, Weaver DL, Alex JC, et al. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol. 1993;2:335–9. discussion 340.

    Article  PubMed  CAS  Google Scholar 

  62. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–8. discussion 398–401.

    Article  PubMed  CAS  Google Scholar 

  63. Mamounas EP, Brown A, Anderson S, et al. Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2005;23:2694–702.

    Article  PubMed  Google Scholar 

  64. Classe JM, Bordes V, Campion L, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy for advanced breast cancer: results of Ganglion Sentinelle et Chimiotherapie Neoadjuvante, a French prospective multicentric study. J Clin Oncol. 2009;27:726–32.

    Article  PubMed  Google Scholar 

  65. Xing Y, Foy M, Cox DD, et al. Meta-analysis of sentinel lymph node biopsy after preoperative chemotherapy in patients with breast cancer. Br J Surg. 2006;93:539–46.

    Article  PubMed  CAS  Google Scholar 

  66. • Kelly AM, Dwamena B, Cronin P, et al. Breast cancer sentinel node identification and classification after neoadjuvant chemotherapy-systematic review and meta analysis. Acad Radiol. 2009;16:551–63. Meta-analysis of sentinel node biopsy after neoadjuvant chemotherapy.

    Article  PubMed  Google Scholar 

  67. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer—a multicenter validation study. N Engl J Med. 1998;339:941–6.

    Article  PubMed  CAS  Google Scholar 

  68. • Shen J, Gilcrease MZ, Babiera GV, et al. Feasibility and accuracy of sentinel lymph node biopsy after preoperative chemotherapy in breast cancer patients with documented axillary metastases. Cancer. 2007;109:1255–63. Initial experience with sentinel node biopsy in patients with documented positive axillary nodes receiving neoadjuvant chemotherapy.

    Article  PubMed  Google Scholar 

  69. • Alvarado R, Yi M, Le-Petross H, et al. The role for sentinel lymph node dissection after neoadjuvant chemotherapy in patients who present with node-positive breast cancer. Ann Surg Oncol. 19:3177–84. More comprehensive update of the MD Anderson experience with sentinel node biopsy in patients with documented positive axillary nodes receiving neoadjuvant chemotherapy.

  70. Lee S, Kim EY, Kang SH, et al. Sentinel node identification rate, but not accuracy, is significantly decreased after pre-operative chemotherapy in axillary node-positive breast cancer patients. Breast Canc Res Treat. 2007;102:283–8.

    Article  CAS  Google Scholar 

  71. Newman EA, Sabel MS, Nees AV, et al. Sentinel lymph node biopsy performed after neoadjuvant chemotherapy is accurate in patients with documented node-positive breast cancer at presentation. Ann Surg Oncol. 2007;14(10):2946–52.

    Google Scholar 

  72. •• Boughey JC, Suman VJ, Mittendorf EA, et al. The role of sentinel lymph node surgery in patients presenting with node positive breast cancer (T0-T4, N1-2) who receive neoadjuvant chemotherapy – results from the ACOSOG Z1071 trial. Cancer Res. 2012;72(24 Suppl):94S. (abstract S2-1). Prospective trial of the performance characteristics of sentinel node biopsy after neoadjuvant chemotherapy in patients with documented axillary node involvement before neoadjuvant chemotherapy.

    Google Scholar 

  73. •• Kuehn T, Bauerfeind IGP, Fehm T, et al. Sentinel lymph node biopsy before or after neoadjuvant chemotherapy - final results from the prospective German, multiinstitutional SENTINA-Trial. Cancer Res. 2012;72(24 Suppl):95S. (abstract S2–2). Prospective trial of the performance characteristics of sentinel node biopsy after neoadjuvant chemotherapy in patients with documented axillary node involvement before neoadjuvant chemotherapy.

    Google Scholar 

  74. Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351:2817–26.

    Article  PubMed  CAS  Google Scholar 

  75. Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24:3726–34.

    Article  PubMed  CAS  Google Scholar 

  76. Albain KS, Barlow WE, Shak S, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomized trial. Lancet Oncol. 2009;11:55–65.

    Google Scholar 

  77. •• Mamounas EP, Anderson SJ, Dignam JJ, et al. Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of National Surgical Adjuvant Breast and Bowel Project B-18 and B-27. J Clin Oncol. 2012;30:3960–6. Large experience with predictors of loco-regional recurrence after neoadjuvant chemotherapy in patients who participated in 2 NSABP neoadjuvant chemotherapy trials where post-mastectomy radiotherapy was not allowed and only post-lumpectomy breast radiotherapy was allowed.

    Article  PubMed  Google Scholar 

  78. Buzdar AU, Ibrahim NK, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85.

    Article  PubMed  CAS  Google Scholar 

  79. Rouzier R, Pusztai L, Delaloge S, et al. Nomograms to predict pathologic complete response and metastasis-free survival after preoperative chemotherapy for breast cancer. J Clin Oncol. 2005;23:8331–9.

    Article  PubMed  Google Scholar 

  80. Aryus B, Audretsch W, Gogolin F, et al. Remission rates following preoperative chemotherapy and radiation therapy in patients with breast cancer. Strahlenther Onkol. 2000;176:411–5.

    Article  PubMed  CAS  Google Scholar 

  81. Gerlach B, Audretsch W, Gogolin F, et al. Remission rates in breast cancer treated with preoperative chemotherapy and radiotherapy. Strahlenther Onkol. 2003;179:306–11.

    Article  PubMed  Google Scholar 

  82. Jacquillat C, Weil M, Baillet F, et al. Results of neoadjuvant chemotherapy and radiation therapy in the breast-conserving treatment of 250 patients with all stages of infiltrative breast cancer. Cancer. 1990;66:119–29.

    Article  PubMed  CAS  Google Scholar 

  83. Scholl SM, Fourquet A, Asselain B, et al. Neoadjuvant vs adjuvant chemotherapy in premenopausal patients with tumors considered too large for breast conserving surgery: preliminary results of a randomized trial: S6. Eur J Cancer. 1994;30A:645–52.

    Article  PubMed  CAS  Google Scholar 

  84. Pusztai L, Ayers M, Simman FW, et al. Emerging science: prospective validation of gene expression profiling-based prediction of complete pathologic response to neoadjuvant paclitaxel/FAC chemotherapy in breast cancer. Proc Am Soc Clin Oncol. 2003;22:1 (abstract 1).

    Google Scholar 

  85. • Jeruss JS, Newman LA, Ayers GD, et al. Factors predicting additional disease in the axilla in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy. Cancer. 2008;112:2646–54. Factors predicting additional disease in the axilla in patients with positive sentinel lymph nodes after neoadjuvant chemotherapy.

    Article  PubMed  Google Scholar 

  86. Hurkmans CW, Borger JH, Rutgers EJ, et al. Quality assurance of axillary radiotherapy in the EORTC AMAROS trial 10981/22023: the dummy run. Radiother Oncol. 2003;68:233–40.

    Article  PubMed  Google Scholar 

  87. Buchholz TA, Strom EA, McNeese MD, et al. Radiation therapy as an adjuvant treatment after sentinel lymph node surgery for breast cancer. Surg Clin N Am. 2003;83:911–30.

    Article  PubMed  Google Scholar 

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Conflict of Interest

E.P. Mamounas has received payment for serving as a consultant to Genomic Health, Celgene, and Genentech and payment for serving on a speaker’s bureau for Genomic Health.

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  1. MD Anderson Cancer Center, Orlando, 1400 S. Orange Avenue, MP700, Orlando, FL, 32806, USA

    Eleftherios P. Mamounas

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Mamounas, E.P. The Impact of Neoadjuvant Chemotherapy on Local-Regional Treatment of Breast Cancer. Curr Breast Cancer Rep 5, 106–117 (2013). https://doi.org/10.1007/s12609-013-0106-z

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