Primary Chemotherapy for Resectable Breast Cancer

Abstract

Primary (neoadjuvant, preoperative) chemotherapy for surgically curative breast cancer is a novel treatment approach. The sequentially combined strategy derives from prior experience achieved with locally advanced (stage III) disease in which primary chemotherapy including a regimen containing doxorubicin (Adriamycin) was delivered to achieve prompt tumor shrinkage and thus facilitate subsequent mastectomy and/or irradiation [1–4]. In recent years primary chemotherapy has been tested in resectable breast cancer with multifold clinical aims: (a) to increase the frequency of breast- saving procedures in tumors whose size would require mastectomy, (b) to decrease the frequency of local recurrence, and (c) to further improve relapse-free and total survival rates over those recently achieved with systemic adjuvant treatments [2, 5, 6] (the latter of these is reprinted in part in this volume). This paper summarizes and updates the clinical results of the prospective trial started in 1988 at the Milan Cancer Institute [7].