Neo-adjuvant systemic therapy

In case of neo-adjuvant or primary chemotherapy, systemic treatment is administered prior to surgery. This approach is generally reserved for those cases in which it is desirable to perform or improve conservative treatment by decreasing initial tumour size. This treatment also has the advantage of providing information on the effectiveness of the in vivo treatment of the tumour. Before beginning this kind of treatment, it is essential to make a precise diagnosis of the tumour biology through a biopsy.

In the case of an inflammatory cancer, it is proposed that chemotherapy be performed before surgery, which, generally speaking, is radical.

If the tumour is HER-2 positive, treatment with Trastuzumab is administered at the same time as chemotherapy. In some patients with tumours strongly expressing hormone receptors, a primary hormonal therapy may sometimes be proposed. If there is an objectified clinical response, this treatment should be administered for 4 to 6 months before surgery.