neoadjuvant treatment for breast cancer - not living up to the promise

Neoadjuvant chemotherapy for breast cancer is a new strategy that was introduced towards the end of the 20th century with the aim of reducing tumour size - rendering an otherwise inoperable tumour operable, allowing more conservative surgery, and hopefully improving overall survival. Although data indicate that the first rationale remains valid, the others have not led to the desired outcomes. More conservative surgery after neoadjuvant chemotherapy can result in a higher rate of local recurrence, and, despite the earlier initiation of systemic treatment, no improvement in survival has been seen. Jayant Vaidya, professor of surgery and oncology and consultant breast cancer surgeon at University College London, joins us to explain why he is rethinking the use of neoadjuvant chemotherapy for breast cancer. Read the full analysis: http://www.bmj.com/content/360/bmj.j5913