Abstract
Multiple studies have evaluated the benefits of treating some poor prognosis and locally advanced breast cancer prior to the primary surgical intervention. Neoadjuvant therapy for breast cancer has several advantages: (1) it initiates systemic therapy early and avoids delays imposed by a primary surgical procedure; (2) preoperative therapy can decrease the size of the primary tumor and convert a mastectomy to a lumpectomy; and (3) preoperative therapy constitutes an in vivo sensitivity assay allowing an assessment of treatment response. In addition, the response to neoadjuvant therapy determines the need and type of postoperative systemic therapy. The burden of pathologically detected residual disease after neoadjuvant chemotherapy is associated with long-term prognosis, and a pathological complete response to systemic therapy is associated with an extremely favorable disease-free and overall survival. Neoadjuvant systemic therapy should be offered to appropriate surgical candidates based on the clinical parameters of newly diagnosed invasive breast cancer.