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Journal of the National Cancer Institute Advance Access originally published online on April 8, 2008
JNCI Journal of the National Cancer Institute 2008 100(8):521-523; doi:10.1093/jnci/djn098
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© The Author 2008. Published by Oxford University Press.

EDITORIALS

Can Early Response Assessment Guide Neoadjuvant Chemotherapy in Early-Stage Breast Cancer?

Francisco J. Esteva, Gabriel N. Hortobagyi

Affiliation of authors: Department of Breast Medical Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX

Correspondence to: Francisco J. Esteva, MD, PhD, Department of Breast Medical Oncology, University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Blvd—Unit 1354, Houston, TX 77030 (e-mail: festeva@mdanderson.org).

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Randomized clinical trials conducted over the last three decades have shown that systemic adjuvant therapy reduces the risk of recurrence and death in patients with early-stage breast cancer. In patients with locally advanced and inflammatory breast cancer, the use of chemotherapy before surgery (neoadjuvant or preoperative approach) is the standard of care. A clinical and/or radiological response is achieved in most patients, and this response facilitates optimal surgery and radiation therapy. The success of neoadjuvant chemotherapy for locally advanced breast cancer, combined with emerging data on the use of adjuvant chemotherapy, led to studies investigating neoadjuvant chemotherapy among women with operable breast cancer. Randomized clinical trials of adjuvant vs neoadjuvant chemotherapy in patients with early-stage operable breast cancer showed no difference in disease-free or overall survival rates. Potential advantages of the . . . [Full Text of this Article]


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