Evolutionary development of adjuvant radiotherapy for breast cancer. Part II. The role of neoadjuvant systemic chemotherapy

Neoadjuvant systemic chemotherapy (NASCT) is a possible therapeutic approach for the treatment of locally advanced, predominantly inoperable or inflammatory breast cancer. The use of NASCT in operable breast cancer now continues to expand due to the possibility of more frequent organ-preserving surgeries following it and the determination of an early response to systemic treatment. It is not yet definitively clear whether NASCT can improve the results of specific treatment in certain subgroups of breast cancer patients. The most important parameter corresponding to the real possibility of the ultimate success of special treatment and improving overall patient survival is the achievement of complete pathomorphological response (CPMR) to NASCT. At the same time, the identification of subgroups of patients with high rates of CPMR may allow for less invasive surgical or even radiotherapy interventions necessary after its implementation, and other modern antitumor systemic treatment methods can be used for patients who have not achieved CPMR .