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Neoadjuvant chemotherapy is being used with increasing
frequency in the multidisciplinary treatment of
patients with operable breast cancer. Although large
clinical trials have shown no differences between the same
systemic therapy given pre- or post-surgery on diseasefree
and overall survival, neoadjuvant therapy may have
several advantages. By downstaging of the tumor,
chemotherapy can convert patients who are candidates
for mastectomy to breast-conserving surgery candidates.
Furthermore, it has potential to reduce excision volumes
in patients with large cancer who are already candidates
for breast conserving surgery improving cosmetic outcomes.
Another surgical advantage is downstaging of the
axilla so that lymph node dissection can be avoided in
selected patients reducing surgical morbidity.
