Preoperative Chemotherapy for Operable Breast Cancer
During the past 25 years, there has been a significant change in the way in which operable breast cancer is managed. As a result of laboratory and clinical investigations conducted during the 1960s, evidence was obtained that challenged Halstedian principles of tumor dissemination and provided support for an alternative hypothesis.1 Findings from subsequent randomized clinical trials demonstrated that the extent of surgical resection had no effect on the patient’s outcome2 and that the administration of systemic therapy after surgery significantly improved the disease-free survival (DFS) and survival of such patients.3 Consequently, there was a shift in emphasis away from surgery as the sole treatment for breast cancer, and systemic therapy became an integral part of the management of the disease.
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