Breast Disease pp 281-292 | Cite as

Surgical Treatment in Operable Breast Cancer After Neoadjuvant Systemic Therapy

  • Atilla SoranEmail author
  • Ebru Menekse
  • Kandace P. McGuire


The primary goal of neoadjuvant chemotherapy (NCT) in operable breast cancer is tumor downsizing to facilitate breast-conserving surgery (BCS), and it may give a chance for less aggressive lymph node surgery. The use of NCT in early-stage breast cancer in carefully selected patients is increasing. Despite a shift in the treated patient population to patients with earlier-stage tumors, the principles of surgery after NCT remain the same. Monitoring response to therapy is important for surgical planning and prognostic information. Preoperative marking of the tumor is essential for guiding BCS after NCT and should be performed in all patients. Early literature supported the use of pre-NCT sentinel lymph node biopsy (SLNB), but current literature suggests increased accuracy and decreased use of axillary dissection in patients who undergo SLNB after NCT regardless of clinical lymph node status prior to NCT. A multidisciplinary approach to breast cancer care is essential during NCT for improved outcomes and decreased morbidity.


Breast cancer Chemotherapy Neoadjuvant treatment Surgery Surgical procedure 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Atilla Soran
    • 1
    Email author
  • Ebru Menekse
    • 1
  • Kandace P. McGuire
    • 2
    • 3
  1. 1.Division of Surgical Oncology, Department of SurgeryUniversity of Pittsburgh School of Medicine, Magee-Women’s Hospital of UPMCPittsburghUSA
  2. 2.Division of Surgical Oncology, Department of SurgeryVirginia Commonwealth UniversityRichmondUSA
  3. 3.Section of Breast SurgeryMassey Cancer Center at Virginia Commonwealth UniversityRichmondUnited States

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