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Breast Cancer

The Value of Preoperative Chemotherapy

  • Review Article
  • Published:
American Journal of Cancer

Abstract

The current attractiveness of preoperative chemotherapy for breast cancer lies in its ability to down-stage both the primary tumor and the axillary lymph nodes, making many patients good candidates for breast-conserving surgical techniques. This has been an important achievement, particularly for patients considered to have inoperable tumors. Attention has recently turned to the use of preoperative chemotherapy for patients with operable tumors. Among patients with resectable stage II or III breast tumors, preoperative chemotherapy has been demonstrated to effectively down-stage the primary tumor, and subsequent breastconserving surgery has resulted in excellent local control. In addition, preoperative chemotherapy has been shown to down-stage axillary lymph nodes from positive to negative in significant numbers of cases. This finding raises the question of whether patients who have clinically negative axillae after preoperative chemotherapy need to risk the morbidity associated with axillary lymph node dissection. Axillary irradiation may provide adequate regional control in patients who are clinically node-negative. In addition, sentinel lymph node dissection has been shown to provide accurate assessment of the axilla in patients who have received preoperative chemotherapy. Future directions with the concept of preoperative chemotherapy focus on the possibility that primary tumor ablation that takes place after the completion of systemic therapy can become minimally invasive, and thus can be done in an outpatient setting without the need for an operating room suite.

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Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The author has no conflicts of interest that are directly relevant to the contents of this manuscript.

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  1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 444, Houston, TX, 77030-4095, USA

    S. Eva Singletary

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  1. S. Eva Singletary
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Correspondence to S. Eva Singletary.

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Singletary, S.E. Breast Cancer. Am J Cancer 1, 121–126 (2002). https://doi.org/10.2165/00024669-200201020-00005

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  • DOI: https://doi.org/10.2165/00024669-200201020-00005

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