When and why to indicate breast cancer radiotherapy after neoadjuvant systemic therapy

04/2019

Doc. MUDr. Renata Soumarová, Ph.D.; MUDr. Lenka Rušínová

Radioterapeutická a onkologická klinika 3. LF UK a FN Královské Vinohrady, Praha

SUMMARY

Adjuvant radiotherapy after both radical and partial mastectomy has an effect on local disease control as well as overall survival, as evidenced by large studies with long-term follow-up. However, postoperative radiotherapy indications for patients after neoadjuvant chemotherapy are controversial. This is due to a different tumor response to neoadjuvant treatment and a lack of prospective studies. Currently, when considering post-operative radiotherapy after neoadjuvant treatment, both the very accurate pre-treatment classification and the tumor characteristics including molecular subtypes and the definitive pathological classification must be taken into account. The most difficult decision is especially in the group of patients who have achieved a pathological complete response.

Key words

neoadjuvant chemotherapy, radiotherapy after mastectomy, locoregional recurrence