Primary chemotherapy in operable breast cancer

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Primary chemotherapy, a multimodal approach for locally advanced breast cancer, has evolved over two decades.
• It is increasingly adopted globally for large, resectable breast cancers, involving chemotherapy, surgery, and radiation.
• Existing studies show significant heterogeneity in patient selection, treatment protocols, and outcome assessments.

Purpose of the Study:

• To review the current knowledge on primary chemotherapy in breast cancer management.
• To discuss the benefits, including tumor shrinkage and systemic micrometastasis eradication.
• To outline future research directions for this multidisciplinary approach.

Main Methods:

• This is a review article summarizing existing literature on primary chemotherapy for breast cancer.
• It synthesizes data on patient selection, treatment modalities, and response criteria.
• It analyzes the impact on surgical outcomes and systemic disease control.

Main Results:

• Primary chemotherapy leads to prompt tumor shrinkage, facilitating breast-conserving surgery.
• It is crucial for eradicating systemic micrometastases, a key goal of early chemotherapy.
• The approach shows promise but requires further validation.

Conclusions:

• Primary chemotherapy is a valuable tool in managing resectable breast cancer, enhancing surgical options and systemic control.
• High-quality prospective studies are essential to definitively establish its superiority over classical adjuvant treatments regarding relapse-free survival.
• Continued research is warranted to optimize this multidisciplinary strategy.