Neoadjuvant chemotherapy for breast cancer

Neoadjuvant chemotherapy not only makes surgical removal easier, but also makes the unremovable part resectable, significantly improving the treatment effect on the tumor. Moreover, when the existing subclinical metastatic lesions are sufficiently controlled by whole-body radiotherapy, the patient's survival rate is also improved. Next, let's discuss what is neoadjuvant chemotherapy for breast cancer?

What is neoadjuvant chemotherapy for breast cancer?

The so-called neoadjuvant chemotherapy refers to radiotherapy before the patient undergoes surgery. Neoadjuvant chemotherapy for breast cancer patients is mainly used in the following situations: First, the tumors of some patients are very large, and direct surgery is difficult. Neoadjuvant chemotherapy can be used to shrink the tumors and provide opportunities for surgery. Second, some patients are unwilling to undergo breast incision and want to preserve part of their breast. Neoadjuvant chemotherapy can increase the treatment rate of breast-conserving surgery. Third, according to clinical experiments, some patients who receive neoadjuvant chemotherapy followed by surgery have a lower recurrence rate than those who undergo surgery first and then radiotherapy. According to the 2017 edition of the CBCS Chinese Anti-Cancer Association Breast Cancer Treatment Manual and Standards, neoadjuvant chemotherapy is strongly recommended for the following patients: First, the tumor is >5cm. Second, cancer metastasis is positive. Third, if the tumor is between 2cm and 5cm in size and is HER2-positive or triple-negative, neoadjuvant chemotherapy is strongly recommended for these patients. The above questions are for reference only. The actual medication and treatment should be based on the doctor's preoperative diagnosis and guidance.

Neoadjuvant chemotherapy plan and cycle time for breast cancer:

All effective chemotherapy drugs and regimens for breast cancer can be used as neoadjuvant chemotherapy regimens.

Neoadjuvant chemotherapy should last for 3 to 4 cycles. Radiotherapy will not be effective if it lasts for ≤2 cycles. Some drugs must be used in a certain cumulative amount to achieve the best effect. Studies have shown that the effect of neoadjuvant chemotherapy in reducing the size of tumors and lymph nodes (downstaging) was significantly better in the 4-cycle group than in the 2-cycle group. In clinical care, we often observe that significant tumor shrinkage usually occurs in the middle and late stages of the second cycle. Judging from the recent efficacy and the occurrence of pathological complete remission cases, it is more appropriate to use more than three cycles of neoadjuvant chemotherapy, but its impact on the long-term survival rate of patients still needs further scientific research.