Surgical considerations for breast cancer patients receiving neoadjuvant systemic therapy. (September 2013)

• Record Type: Journal Article
• Authors: Hunt, Kelly K; Mittendorf, Elizabeth A
• Is Part Of: Breast cancer management. Volume 2:Number 5(2013)
• Page Start: 385
• Page End: 395
• Publication Date: 2013-09
• Subjects: Breast -- Cancer -- Periodicals; Breast -- Cancer -- Treatment -- Periodicals; 616.9944905
• DOI: 10.2217/bmt.13.38
• Languages: English
• ISSNs: 1758-1923

Abstract

SUMMARY In appropriately selected patients whose tumors respond to neoadjuvant chemotherapy, breast-conserving therapy can be performed with excellent rates of locoregional control. Not all patients become breast-conserving therapy candidates, and in those who require mastectomy, recommendations regarding reconstruction may be influenced by whether a patient will be advised to consider postmastectomy radiation therapy. For patients with clinically node-negative disease, sentinel lymph node dissection performed after neoadjuvant chemotherapy is technically feasible and accurate and results in fewer patients with a positive sentinel lymph node, and therefore fewer patients requiring axillary lymph node dissection. For patients presenting with node-positive disease, a significant percentage will become node-negative with neoadjuvant chemotherapy, and recent trials have been designed to assess the use of sentinel lymph node dissection in select patients.