Abstract
Presurgical chemotherapy is increasingly implemented as it improves breast conservation rates and may reveal novel information about therapeutic response. However, neoadjuvant therapy raises questions about prognosis and decision making for adjuvant local-regional therapy. Current prognostic information and therapeutic treatment planning is typically based on American Joint Committee on Cancer staging information for patients treated with adjuvant therapy. This information is not readily applicable to patients treated with neoadjuvant chemotherapy, however, as neither pretreatment clinical staging data nor post-treatment pathologic data alone accurately reflect disease status. This review summarizes the implementation of a new staging system for patients receiving neoadjuvant therapy. This system combines clinical and pathologic staging factors with biologic markers to refine the prognostic assessment of patients treated with neoadjuvant therapy. Controversies related to neoadjuvant therapy and sentinel lymph node biopsy, postmastectomy radiation therapy, and breast conservation are also discussed.
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Jeruss, J.S. Prognostic outcomes and decision-making for local-regional therapy after neoadjuvant chemotherapy: Pretreatment clinical staging or posttreatment pathologic staging?. Curr Breast Cancer Rep 1, 90–97 (2009). https://doi.org/10.1007/s12609-009-0013-5
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DOI: https://doi.org/10.1007/s12609-009-0013-5