Neoadjuvant or Adjuvant Systemic Treatment for Early Breast Cancer: A Radiation Oncology Perspective
Keywords:
Breast cancer, Chemotherapy, Neoadjuvant, AdjuvantAbstract
Background: Optimal management of breast cancer patients warrants thorough multidisciplinary and individualized as
sessment by surgical oncology, medical oncology, and radiation oncology. Chemotherapy, which constitutes a major com
ponent of multimodality breast cancer management, may be used in the neoadjuvant or adjuvant setting with promising
outcomes. Utility of neoadjuvant or adjuvant chemotherapy in multimodality management of early breast cancer has been
debated and is currently an area of active investigation. Materials and Methods: We provide a concise review of neoadjuvant versus adjuvant chemotherapy for early breast cancer from a radiation oncology perspective in light of the literature with focus on recent studies and high quality evidence. Results: In the context of systemic management of breast cancer, an important focus in research is about sequencing of chemotherapy as neoadjuvant or adjuvant treatment. Neoadjuvant chemotherapy approach may provide tumor downsizing and consequent reduction in extent of surgery. Recent concepts also include its utilization for operable breast cancer patients with accumulating data in support of this strategy.Conclusion: Several strategies are being investigated to improve the therapeutic ratio for patients suffering from breast cancer. Response to neoadjuvant chemotherapy may have several implications for prognosis and decision making. While neoadjuvant therapy was primarily utilized for management of inoperable breast cancers previously, its use has expanded with growing body of evidence from recent studies. Clearly, future studies are warranted to assess neoadjuvant and adjuvant chemotherapy for early breast cancer management.
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