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The use of neoadjuvant therapy is well established in the treatment of the breast cancer, and neoadjuvant endocrine therapy is emerging as a safe and an effective alternative to chemotherapy in selected patients with a hormone receptor–positive locally advanced breast cancer without compromising survival rates. Neoadjuvant endocrine therapy increases the rate of breast conservative surgery in women initially requiring mastectomy, and the latest generation of endocrine therapy, the aromatase inhibitors, has been proved to be superior to tamoxifen. Biomarkers such as Ki67, estrogen receptor, and the PEPI index can be used to select and monitor patients if neoadjuvant endocrine therapy is considered. Biomarkers can give predictive information in weeks, and alternative treatment can be considered before or after surgical resection. The benefits of the neoadjuvant approach are not only tumor size reduction to improve surgical approach, but also to better understand the impact of the treatment on the tumor and treatment resistance due to tumor heterogeneity.
Current Breast Cancer Reports – Springer Journals
Published: Apr 13, 2012
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