De-escalation of neoadjuvant therapy as an option for patients with Her2 positive breast cancer

Breast cancer is the most common female cancer and cause of death from cancer in women worldwide. Overexpression of HER2 / neu, which is an unfavorable predictor associated with a more aggressive course of the disease, is detected in every 5th breast cancer patient. Over the past 20 years, targeted therapy has changed the natural course of breast cancer. However, standard neoadjuvant chemotherapy regimens in combination with targeted therapy are poorly tolerated and, therefore, are considered suboptimal. Evidently, not all patients require such toxic treatment regimens. In this review article, we present our view whether neoadjuvant therapy can be de-escalated in patients with HER2-positive breast cancer.