Unit:
Κατεύθυνση Χειρουργική ΟγκολογίαLibrary of the School of Health Sciences
Author:
Seferli Stavroula
Supervisors info:
Κωνσταντίνος Τούτουζας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Ζωγράφος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Θεοδώρου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Νεο-επικουρική Χημειοθεραπεία στον καρκίνο μαστού: Κλινικές μελέτες, ανασκόπηση και προοπτικές
Translated title:
Neoadjuvant Chemotherapy in breast cancer: Clinical studies, a review and future perspectives
Summary:
Neoadjuvant therapy holds a key role in the treatment of breast cancer. Although initially applied in cases of locally advanced disease or inflammatory tumors (aiming for less radical excisions) or managing inoperable tumors, subsequent extended research on the matter highlighted multiple benefits from the neoadjuvant therapy in various stages of the disease. Applied prior to the definite surgical treatment, neoadjuvant therapy was found to improve several prognostic factors, including overall survival. Inoperable tumors can be rendered resectable, facilitating breast conserving surgical techniques, as it causes both the initial tumor and the axillary lymph nodes to decrease in size. Thus, the clinical stage of the disease can be downgraded, with a favorable effect on the final prognosis. Furthermore, neoadjuvant therapy can evaluate the tumor’s clinical response, guiding towards a more precise choice of the proper adjuvant treatment. In certain patients, even a pathologic complete response (pCR) can be achieved by neoadjuvant therapy alone, leading to tumor eradication and excellent long term results. Neoadjuvant therapy’s most important contribution is noted in patients with aggressive phenotypes, such as triple negative breast cancer (TNBC) and HER2(+) breast cancer. This review of the literature follows the most important milestones in the evolution of neoadjuvant therapy, offering an analysis on the benefits that stem from applying the treatment, citing the most influential studies that shaped current clinical practice of neoadjuvant therapy, describing patient eligibility criteria, documenting the method’s usefulness in specific clinical and pathologic subtypes of breast tumors and shedding light on potential future directions in neoadjuvant therapy for breast cancer.
Main subject category:
Health Sciences
Keywords:
Breast cancer, Neoadjuvant chemotherapy. Biomarkers, Predictive factors, pCR, breast-conserving surgery
