| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3803975 | Medicina Clínica | 2006 | 9 Pages |
La quimioterapia preoperatoria o neoadyuvante es aquella que se administra después del diagnóstico histológico y antes del tratamiento quirúrgico. En ensayos clÃnicos aleatorizados se ha demostrado que la supervivencia al administrar la quimioterapia en el cáncer de mama antes o después de la intervención quirúrgica es idéntica. El tratamiento preoperatorio permite un aumento de la tasa de cirugÃa conservadora, medir la respuesta tumoral y estudiar nuevos marcadores biológicos que ayuden a conocer los mecanismos que inducen la muerte celular y la resistencia a la quimioterapia. Sin embargo, obliga a estudiar nuevos factores pronósticos y a valorar el abordaje quirúrgico y radioterápico óptimo tras una cirugÃa conservadora en una paciente que ha recibido quimioterapia.
Preoperative or neoadjuvant systemic treatment refers to either the first postdiagnosis systemic treatment that a patient receives or indicates that additional subsequent therapy is intended. Randomized controlled clinical trials have shown that preoperative systemic treatment offers the same disease free survival and overall survival benefits as does adjuvant systemic treatment. Neoadjuvant therapy has been found to increase the breast-conserving surgery rate. This therapy also allows to evaluate the primary tumor response to chemotherapy. Additionally, on the basis of the biologic characteristics of a tumor and differences in the response to systemic treatment, primary systemic treatment should be regarded as a tool that can be used to individualize systemic treatment for patients with breast cancer. However, some issues remain to be resolved, such as the markers that should be assessed before this therapy, as well as the optimal surgical and radiotherapy treatment.
