[The development of neoadjuvant chemotherapy in breast cancer]

In the beginning, neoadjuvant chemotherapy (NAC) is part of the multidisciplinary treatment of locally advanced breast cancer. Many clinical trials in the past have developed the usefulness of anthracycline containing NAC for operable breast cancer. The majority of trials have proven survival rates equivalent to adjuvant chemotherapy with increased breast conservation rates, and have also shown that a pathological complete response (pCR) after NAC is associated with improved survival. Taxanes have been introduced into clinical trials of NAC with increased pCR rates. However, there was no significant difference in overall survival among the regimens which added taxanes to neoadjuvant anthracycline. In this paper, the problems of NAC up to the present and the development of new regimens are discussed. We also discuss the new concept of NAC which might revolutionize what we know about NAC.