New Trends in Management of Locally Advanced Breast Cancer

Abstract

NCT is used increasingly in the treatment of breast cancer for the following reasons; first, NCT allows more patients to be treated with BCS; second, it enables an in vivo evaluation of tumor sensitivity to the chemoterapeutic agents; third, tumor response to NCT serves as a predictor of favorable prognosis. NCT also is a key role for translational research. Tumor response to NCT appears to be a surrogate marker for the re­ sponse of occult micrometastases. NCT increase the respectability rate of breast cancer and thus allows more patients to undergo BCS. BCT is a safe and effective alternative to mastectomy for selected patients after NCT. If the primary tumor is operable, but is not suitable for BCS, neoadjuvant therapy is an alternative approach. SLNB is an accurate and safe method to assess axillary nodal status and it has replaced traditional axillary dissection as an initial staging procedure in early stage, clinically nodenegative breast cancer patients. The use of SLNB has been accepted as an alternative approach to axillary dissection in NI­LABC patients with neoadjuvant therapy. There is controversy about the appropriate timing of SLNB in patient with LABC receiving NCT. Preoperative chemotherapy yields reactive changes like fibrosis which can affect lymphatic drainage patterns, however, SLNB after NCT has been used as a safe approach.