Locoregional recurrence after neoadjuvant chemotherapy

Neoadjuvant chemotherapy (NAC) is a widely accepted treatment for operable early breast cancer. The advantages of NAC included the evaluation of the in vivo chemosensitivity of tumors in individual patients, minimisation of micrometastases, and surgical downstaging of tumors. National Surgical Adjuvant Breast and Bowel Project (NSABP) conducted two trials of NAC, namely NSABP B-18 (1) and NSABP B-27 (2). NSABP B-18 demonstrated that no statistically significant overall differences in survival or disease-free survival between the two treatment groups, NAC and postoperative adjuvant therapy. In both studies, patients who achieved a pCR continue to have significantly superior disease-free survival and overall survival outcomes compared with patients who did not (3).