Neo-Adjuvant Treatment of Breast Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 1588

Special Issue Editor


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Guest Editor
Department of Medical Oncology, Shaare Zedek Medical Center, Str. Beit Shmuel 12, Jerusalem 91031, Israel
Interests: breast cancer

Special Issue Information

Dear Colleagues,

Adjuvant or post-surgery care has always been the norm in breast cancer treatment. After the success of the pioneering clinical trials of adjuvant chemotherapy, adjuvant hormonal therapy was introduced successfully as well. On the other hand, treatment before surgery, neo-adjuvant, was only recommended for large or inflammatory breast cancer. Clinicians preferred to administer adjuvant treatment only after a complete pathological report was obtained following surgery, thus avoiding treatment before curative surgery.

Recently, neo-adjuvant therapy has become popular in many cancer types including melanoma, NSCLC, colon cancer, and more. Breast cancer patients who were HER2 positive were the first to be recommended with neo-adjuvant treatment, without regard to size or any other tumor characteristics. Today, neo-adjuvant chemotherapy or hormonal therapy, or even immunotherapy are frequently recommended for patients with breast cancer. It appears that the advantages of neo-adjuvant treatment are recognized, and its shortcomings are negligible. It is imperative that the biology of the many subtypes of breast cancer and its various stages at diagnosis are investigated in order to offer the patients the best treatment at the correct time.

In this Special Issue of Cancers, we aim to discuss the new indications for neo-adjuvant therapy, with a particular focus on the biology and clinical use of this treatment for breast cancer.

Dr. Raphael Catane
Guest Editor

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Keywords

  • neo-adjuvant
  • breast cancer
  • chemotherapy
  • hormonal therapy
  • immunotherapy
  • breast cancer survival
  • breast cancer surgery
  • Norton–Simon hypothesis

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Published Papers (1 paper)

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12 pages, 1749 KiB  
Systematic Review
Wire-Free Targeted Axillary Dissection: A Pooled Analysis of 1300+ Cases Post-Neoadjuvant Systemic Therapy in Node-Positive Early Breast Cancer
by Jajini Varghese, Neill Patani, Umar Wazir, Shonnelly Novintan, Michael J. Michell, Anmol Malhotra, Kinan Mokbel and Kefah Mokbel
Cancers 2024, 16(12), 2172; https://doi.org/10.3390/cancers16122172 - 7 Jun 2024
Viewed by 1120
Abstract
Recent advances in neoadjuvant systemic therapy (NST) have significantly improved pathologic complete response rates in early breast cancer, challenging the role of axillary lymph node dissection in nose-positive patients. Targeted axillary dissection (TAD) integrates marked lymph node biopsy (MLNB) and tracer-guided sentinel lymph [...] Read more.
Recent advances in neoadjuvant systemic therapy (NST) have significantly improved pathologic complete response rates in early breast cancer, challenging the role of axillary lymph node dissection in nose-positive patients. Targeted axillary dissection (TAD) integrates marked lymph node biopsy (MLNB) and tracer-guided sentinel lymph node biopsy (SLNB). The introduction of new wire-free localisation markers (LMs) has streamlined TAD and increased its adoption. The primary endpoints include the successful localisation and retrieval rates of LMs. The secondary endpoints include the pathological complete response (pCR), SLNB, and MLNB concordance, as well as false-negative rates. Seventeen studies encompassing 1358 TAD procedures in 1355 met the inclusion criteria. The localisation and retrieval rate of LMs were 97% and 99%. A concordance rate of 67% (95% CI: 64–70) between SLNB and MLNB was demonstrated. Notably, 49 days (range: 0–272) was the average LM deployment time to surgery. pCR was observed in 46% (95% CI: 43–49) of cases, with no significant procedure-related complications. Omitting MLNB or SLNB would have under-staged the axilla in 15.2% or 5.4% (p = 0.0001) of cases, respectively. MLNB inclusion in axillary staging post-NST for initially node-positive patients is crucial. The radiation-free Savi Scout, with its minimal MRI artefacts, is the preferred technology for TAD. Full article
(This article belongs to the Special Issue Neo-Adjuvant Treatment of Breast Cancer)
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