Wankhade Dhanashree, Gharde Pankaj, Dutta Sushmita
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2023 Nov 30;15(11):e49742. doi: 10.7759/cureus.49742. eCollection 2023 Nov.
Currently, the prevailing approach for managing breast carcinoma involves initiating neoadjuvant chemotherapy (NAC) as a part of the treatment regimen before surgery. NAC is being applied progressively in the therapeutic management of locally advanced breast carcinoma because of its capability to aid in surgery and facilitate the surgical treatment of patients who were once thought to be inoperable. Patients must be managed by a team of professionals from the start to the completion of the therapy. Pathological complete response (pCR), reduces the degree of recurrence of the disease and denotes the elimination of the tumor completely from the breast, it also indicates elimination of the tumor from the axillary lymph nodes. There is currently sufficient information to support the idea that patients would perform better if NAC resulted in a pCR. The administration of the same regimen of adjuvant therapy in neoadjuvant therapy provides women with similar improvements in overall survival. NAC offers potential benefits, such as enhancing the likelihood of breast conservation and broadening the scope of available surgical options. Based on how well they respond to neoadjuvant treatment, women receive a personalized prognosis evaluation. NAC has been proven to be very effective. However, patients can be resistant to medications easily which is not desirable for patients receiving this therapy going forward. In this review, we have discussed the purpose of managing patients with this therapy in locally advanced breast cancer. We have also discussed the various benefits of NAC as well as the application of different drugs, their advantages, and disadvantages that are given to the patient. The application of NAC in cases of human epidermal growth factor 2 (HER2) positive breast cancer and micropapillary breast cancer has also been discussed briefly in this review.
目前,治疗乳腺癌的主流方法是在手术前将新辅助化疗(NAC)作为治疗方案的一部分。由于NAC有助于手术,并能为那些曾被认为无法手术的患者提供手术治疗,因此它在局部晚期乳腺癌的治疗管理中得到了越来越广泛的应用。从治疗开始到结束,患者都必须由专业团队进行管理。病理完全缓解(pCR)可降低疾病复发程度,意味着肿瘤已从乳房中完全清除,也表明腋窝淋巴结中的肿瘤已被清除。目前有足够的信息支持这样的观点,即如果NAC能导致pCR,患者的预后会更好。在新辅助治疗中使用相同方案的辅助治疗,能使女性患者的总生存率得到类似的提高。NAC具有潜在的益处,比如增加保乳的可能性并拓宽可用手术选择的范围。根据女性对新辅助治疗的反应情况,她们会接受个性化的预后评估。NAC已被证明非常有效。然而,患者可能很容易对药物产生耐药性,这对接受该治疗的患者来说是不利的。在这篇综述中,我们讨论了在局部晚期乳腺癌中使用这种疗法治疗患者的目的。我们还讨论了NAC的各种益处以及不同药物的应用、它们给予患者的优缺点。本文还简要讨论了NAC在人表皮生长因子2(HER2)阳性乳腺癌和微乳头乳腺癌病例中的应用。