Breast Cancer: Targets and Therapy (Mar 2021)
Approaching Neoadjuvant Therapy in the Management of Early-Stage Breast Cancer
Abstract
Tara Hyder,1 Saveri Bhattacharya,2,* Kristine Gade,3,* Azadeh Nasrazadani,3 Adam M Brufsky3 1University of Pittsburgh Physicians, Pittsburgh, PA, USA; 2Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA; 3UPMC Hillman Cancer Center, Magee Women’s Hospital, Pittsburgh, PA, USA*These authors contributed equally to this workCorrespondence: Adam M BrufskyUPMC Hillman Cancer Center, Magee Women’s Hospital, Suite 4628, 300 Halket Street, Pittsburgh, PA, 15213, USAEmail [email protected]: Neoadjuvant therapy is integral to the treatment of early-stage breast cancer. Goals of treatment include surgical downstaging of the tumor, rendering inoperable tumors resectable, and de-escalating axillary surgery in those with clinically positive nodes. Additionally, response to treatment provides important prognostic information regarding risk of recurrence and guides future adjuvant treatment. Although chemotherapy serves as the backbone of neoadjuvant treatment, an increased understanding of the tumor’s clinical course as well as its molecular and genetic make-up aids in individualizing treatment and developing novel agents. This review summarizes current clinical approaches and the future direction to the management of breast cancer patients in the neoadjuvant setting.Keywords: neoadjuvant chemotherapy, neoadjuvant endocrine therapy, pCR, breast-conserving surgery