BMJ: Rethinking neoadjuvant chemotherapy for breast cancer

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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