Neoadjuvant Therapy: The Ultimate Interdisciplinary Challenge

The modern treatment of breast cancer requires a collaborative, interdisciplinary approach. This is particularly the case with the use of neoadjuvant systemic therapy (NST). Optimal treatment requires participating physicians to have well-defined roles and “shared protocols” to follow. Interdisciplinary prospective conferences provide the forum for treatment planning and ongoing assessment. NST allows less surgery, gives important prognostic information, and is a valuable clinical research approach. With the better selection of patients for neoadjuvant therapy and with the advent of more effective systemic treatments, the extent of surgery and radiation necessary for adequate local control will need to be determined. The use of neoadjuvant therapy in breast cancer as part of a combined multimodality approach has become well established. It requires an organizational framework that facilitates the various oncology specialists working together toward a common goal of optimal treatment.