Neoadjuvant Chemotherapy: Mammographic-Pathologic Correlation

The use of neoadjuvant chemotherapy (NACT) or neoadjuvant systemic therapy (NST) for breast cancers has increased significantly. NACT is, by definition, utilized, before surgery and before radiation therapy. The idea behind this type of treatment is to be able to eradicate potential systemic micrometastatic foci and produce shrinkage of the primary tumor. Some cases are treated to convert inoperable cancers into operable ones; other cases are treated to allow breast conservation. One of the concerns with the use of NACT is a reported increase in local recurrence after breast conserving surgery. It is therefore critical for accuracy of results and margin evaluation that the radiologic and pathologic evaluations are performed in an interdisciplinary forum. Evaluation of the imaging studies in conjunction with the pathologic information provides the most accurate information regarding residual versus no residual disease.