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Chemotherapy before Surgery (Neoadjuvant Chemotherapy)
What Is Neoadjuvant Chemotherapy?
When chemotherapy is your first treatment for cancer, it’s called ‘‘neoadjuvant therapy.’’
It’s often used for advanced breast cancer or large tumors that complicate surgery. But it has other equally important benefits.
When chemotherapy is the first step in your breast cancer treatment, it’s called Neoadjuvant therapies are systemic therapies that come before a main treatment.
Because there are several kinds of breast cancer, not everyone receives the same treatment in the same order. Though neoadjuvant chemotherapy is a good option for some people with breast cancer, it’s not the best choice for everyone.
Neoadjuvant Chemotherapy and Main Treatments in Breast Cancer:
You receive neoadjuvant chemotherapy for breast cancer before your main treatment. In breast cancer, the main treatment is likely to be:
mastectomy
breast-conserving surgery (lumpectomy)
Other treatments include hormone therapy and targeted therapies.
When is neoadjuvant chemotherapy used to treat breast cancer?
Neoadjuvant chemotherapy for breast cancer may be beneficial if you have:
locally advanced breast cancer with lymph node involvement
a large tumor that may complicate surgery
other health concerns that increase the risks of immediate surgery
inflammatory breast cancer
triple-negative breast cancer
HER2-positive breast cancer
There’s a lot to consider, so it comes down to a case-by-case decision. To figure out whether you’re a good candidate, your oncology team will consider any other health concerns you may have.
In addition to a clinical examination, some tests that can help inform the decision are:
breast MRI
breast ultrasound
biopsy
These tests help determine key factors such as:
tumor type
grade (aggressiveness)
whether the cancer has invaded the lymphatic or vascular system
whether the cancer has spread to distant organs/sites (if it has, then surgery is not an option)
In addition to deciding the order of treatments, this information can help determine which chemotherapy drugs are most likely to be effective.
What are the benefits of neoadjuvant chemotherapy?
If you’re not able to have surgery right away, neoadjuvant chemotherapy can get treatment started. This can help keep cancer from spreading before you’re ready for surgery.
And shrinking a large tumor can lower the risk of complications during surgery.
Other potential benefits are:
Evaluating chemotherapy drugs: Your oncologist will monitor the size of the tumor. This makes it easier to see how well chemotherapy is working. You can quickly switch to a different drug if the tumor isn’t shrinking.
Lowering the risk of recurrence: Because chemotherapy is a systemic therapy, it can also kill cancer cells that may have entered the lymphatic or vascular system. This can lower the risk of recurrence.
Less invasive surgery: Shrinking the tumor may make it possible to have breast-conserving surgery rather than a mastectomy. In some cases rusted Source, neoadjuvant chemotherapy may eliminate the need for surgery.
Planning purposes: Starting with chemotherapy gives you more time for genetic testing and making decisions about breast cancer surgery and reconstructive surgery.
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