Role of postmastectomy radiation therapy after neoadjuvant chemotherapy in locally advanced breast cancer

Neoadjuvant chemotherapy for primary breast cancer is the gold standard in the treatment of locally advanced, inoperable breast cancer, and also based on a large body of evidence has become a standard treatment option for patients with operable disease, who are clear candidates for adjuvant chemotherapy. There are several advantages of administering neoadjuvant chemotherapy: tumor downstaging, improving the chance of breast conserving surgery, in vivo assessment of tumor sensitivity to the chosen therapeutic regimen, and early control of micro-metastatic disease. However there are substantially less data to aid in determining which patients treated with neo-adjuvant chemotherapy warrant postmastectomy radiotherapy. According to the recent literature, patients who require mastectomy after systemic therapy should receive postmastectomy radiotherapy.