Division of Medical Oncology, Department of Medicine, Norris Comprehensive Cancer Center, University of Southern California Keck School of Medicine, Los Angeles, California 90033, USA.
J Surg Oncol. 2010 Mar 15;101(4):283-91. doi: 10.1002/jso.21446.
The past few decades have seen an increase in both the role and the complexity of neoadjuvant therapy for breast cancer. Neoadjuvant therapy was initially described as systemic chemotherapy for inflammatory or locally advanced breast cancer but now entails a combination of chemotherapy, endocrine therapy, and targeted therapy. Neoadjuvant systemic therapy is employed for inoperable inflammatory and locally advanced breast cancer, and also for patients with operable breast cancers who desire breast-conserving therapy (BCT) but are not candidates based on the initial size of the tumor in relation to the size of the breast. Neoadjuvant therapy in this subset of patients may impact the surgical options. This review will summarize the benefits of neoadjuvant systemic therapy and implications for BCT, the timing of sentinel node biopsy, and the utility of magnetic resonance imaging (MRI) to predict response to therapy.
过去几十年，新辅助疗法在乳腺癌中的作用和复杂性都有所增加。新辅助疗法最初被描述为用于炎性或局部晚期乳腺癌的全身化疗，但现在包括化疗、内分泌治疗和靶向治疗的联合应用。新辅助全身治疗用于不可手术的炎性和局部晚期乳腺癌，以及那些希望保留乳房的可手术乳腺癌患者，但由于肿瘤与乳房大小的关系，不符合初始标准。这部分患者的新辅助治疗可能会影响手术选择。这篇综述将总结新辅助全身治疗的益处及其对保乳治疗 (BCT) 的影响、前哨淋巴结活检的时机，以及磁共振成像 (MRI) 预测治疗反应的作用。
