Preoperative chemotherapy for operable breast cancer.

In the NSABP B-18 study, it was demonstrated that, in patients with operable breast cancer, the administration of preoperative and postoperative chemotherapy resulted in similar DFS and overall survival outcomes. In addition, preoperative chemotherapy resulted in high clinical response rates but in low rates of pathologic response in the breast. Axillary nodal downstaging was convincingly demonstrated. In addition, it was also demonstrated in B-18, as well as in other studies, that there was an increase in breast conservation rates after the administration of preoperative chemotherapy. The role of preoperative chemotherapy for operable breast cancer continues to be evaluated in randomized trials, which have the potential of providing further insight into the biologic and clinical questions relative to the timing of adjuvant therapy for the disease.