Neoadjuvant Chemotherapy

Traditionally breast cancer was treated by surgery, which was then followed by additional treatments, including radiation therapy, chemotherapy, and hormone blocking therapy.  As breast cancer treatment has evolved, this order of treatment is changing for some breast cancer patients. In some cases, patients now undergo chemotherapy before their breast cancer surgery, or neoadjuvant chemotherapy.


Which Patients Are Candidates for Neoadjuvant Chemotherapy?

  • A patient whose breast cancer is Her2-neu receptor positive
  • A patient with triple-negative breast cancer
  • A patient who wants to save her breast, but has a larger cancer  that first needs to be reduced in size to make it possible for her to undergo lumpectomy rather than mastectomy
  • A young woman who needs chemotherapy to treat her breast cancer but before she can make a decision on surgery will need genetic testing to determine whether or not she carries a breast cancer gene
  • A clinical trial participant who is receiving newer chemotherapy medicines for their breast cancer treatment


How Do We Know That Neoadjuvant Chemotherapy Is Working?

Often, after several courses of chemotherapy, breast cancers will become smaller. Sometimes breast cancers “dissolve,” and when surgery is performed no evidence of the breast cancer can be found. This result is called a complete pathological response.

While not all breast cancer patients will need chemotherapy to treat their disease, if you do require this treatment, you may have options for the timing of chemotherapy delivery. You and your medical team can help determine the most appropriate type of treatment for your cancer, and the best order of treatment delivery.
 

What Is Neoadjuvant Therapy and Why Is It Used?

Richard E. Fine, MD, FACS

Director of Education and Research, The Margaret West Comprehensive Breast Center, Germantown, TN
Associate Professor Department of Surgery, University of Tennessee Health Science Center, College of Medicine

Learn More: Neoadjuvant Hormone Blocking Therapy