Preoperative Chemotherapy for Breast Cancer: Theoretical Considerations, Summary of Research Findings, and Clinical Recommendations

M Cheung

Hong Kong J Radiol 2005;8:30-9

This review summarises the literature on non-randomised and randomised clinical trials on preoperative chemotherapy in breast cancer. The effectiveness and survival benefits of adjuvant anthracycline-based chemotherapy and, more recently, taxanecontaining regimens have led to more frequent use of preoperative chemotherapy as neoadjuvant treatment in operable breast cancers. However, survival benefit has not been shown in randomised controlled trials comparing preoperative chemotherapy with the same regimens used postoperatively or in studies that add taxanes sequentially to anthracycline-containing regimens. Nevertheless, the neoadjuvant setting is an ideal platform for testing new regimens for non–cross-resistance to established regimens and for identifying predictive factors for specific therapies. For the latter, multigene profiling has produced some preliminary and exciting results that may lead to the better selection of patients for specific treatment or that may suggest clues to more effective salvage therapies.