BMJ: Rethinking neoadjuvant chemotherapy for breast cancer

In January 2018, a paper was published in the British Medical Journal questioning the widespread use of neoadjuvant chemotherapy.

Key messages 

  • Neoadjuvant chemotherapy is being increasingly used for breast cancer despite higher rates of local recurrence and no evidence of survival benefit, mainly because of the immediate and dramatic pathological responses seen with newer drugs
  • The increased pathological response of the primary tumour does not translate into a survival benefit even when given in the adjuvant setting, challenging the paradigm of “window of opportunity” studies
  • We must acknowledge that neoadjuvant chemotherapy may not be beneficial to patients
  • We should consider reducing the widespread use of neoadjuvant chemotherapy

The full paper can be accessed at  and along with discussions at Rethinking neoadjuvant chemotherapy for breast cancer – full text and subsequent discussion

A full session was dedicated to it at the Association of Breast Surgeons meeting in June 2018 and in two further meetings in Birmingham and Lincoln. It was most recently discussed at the British Association of Surgical Oncologists- BASO-ACS – NCRI 2018 conference, Glasgow, UK, 4 November 2018

A Tweetorial was published in early November 2018