Abstract
Neoadjuvant therapy is a systemic therapy preceding the surgical procedure consisting in breast cancer removal. In the same way as the adjuvant therapy it results in eradicating the minimal residual disease and extends both disease-free survival and overall survival.
Drugs indicated in adjuvant therapy of patients with HER2-positive tumours include trastuzumab with up to one year of administration: the patient receives the first part of biological treatment as part of neoadjuvant therapy already, followed by the rest of it as part of adjuvant therapy. Patients with hormonal-dependent tumours undergo adjuvant hormonal therapy depending on their menstrual activity.
If we perform breast-conserving procedure after neoadjuvant therapy this should be followed by adjuvant radiotherapy shown to significantly reduce the risk of local recurrence. Patients with cardiac comorbidities may undergo therapy with nonanthracycline regimes as part of the neoadjuvant therapy.
Some patients with hormonal-dependent tumours with low proliferation activity may benefit from hormonal neoadjuvant therapy that is usually administered for 4-6 months. Patients with a HER2-positive tumour should be administered neoadjuvant chemo-biological therapy with trastuzumab, and those of them at higher risk of relapse with additional pertuzumab.