Chemotherapy before Surgery
Chemotherapy given “up front”, before surgery has revolutionised the modern management of breast cancer. Given before surgery, this allows the treating doctors to take fewer risks with chemotherapy prescribing, and allows surgeons to perform smaller operations on patients – and fewer mastectomies in approximately 20%.
The name for this is Neo Adjuvant Chemotherapy (NACT). In published studies, approximately 20% of women who would have needed mastectomy have avoided this with NACT.
For the patient and their oncologist, observing the response of the tumour to NACT affords both the opportunity to witness that the chosen drugs are effective. If the drugs are seen to be not effective, a change can be made.
After removal, the response of the tumour to the NACT, as seen down the microscope offers important information to the treating team about the curability of the patients cancer.
It is estimated that 30% of all breast cancers might be managed this way.
Our goal is to educate and ensure surgeons continue to promote chemotherapy before surgery, where appropriate.
For futher Information:
Read RL, Flitcroft K, Snook KL, Boyle FM, Spillane AJ.
ANZ J Surg. 2015 Jan 22. doi: 10.1111/ans.12975. [Epub ahead of print]