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Locoregional Management of Breast Cancer Following Neoadjuvant Chemotherapy

  • Local-Regional Evaluation and Therapy (A Kong, Section Editor)
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Abstract

Purpose of Review

The treatment of breast cancer is evolving at accelerated rates. As systemic therapy continues to improve, the roles of surgery and radiation are being re-considered. The intent of this review is to discuss recent studies and potential future directions for the locoregional management of breast cancer following neoadjuvant chemotherapy.

Recent Findings

For patients treated with neoadjuvant chemotherapy, treatment decisions hinge on the tumor’s biomarkers and patient’s response to systemic therapy. For patients who sustain a pCR, clinical trials are investigating the role of de-escalated surgery and radiation. For patients with residual disease, escalated systemic therapies have been found to be of benefit. Surgery and radiation remain a mainstay of treatment.

Summary

As the indications for neoadjuvant chemotherapy expand, locoregional management continues to develop and therapy is being increasingly tailored to an individual’s particular response. Practitioners must know when therapy can be safely de-escalated and indications for escalation.

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Funding

This research was supported by The Margie and Robert E. Petersen Foundation and Linda and Jim Lippman.

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Authors and Affiliations

  1. Department of Surgery, University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, 96813, USA

    Ashley D. Marumoto

  2. Department of Surgery, Cedars-Sinai Medical Center, 310 N. San Vicente Boulevard, Los Angeles, CA, 90048, USA

    Armando E. Giuliano

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Correspondence to Armando E. Giuliano.

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Marumoto, A.D., Giuliano, A.E. Locoregional Management of Breast Cancer Following Neoadjuvant Chemotherapy. Curr Breast Cancer Rep 14, 103–112 (2022). https://doi.org/10.1007/s12609-022-00452-4

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