title: Options and limits of surgery after pre-operative chemotherapy in breast cancer.
abstract: The primary administration of chemotherapy leads to a reduction in size of tumors, increasing the possibility of breast-conserving surgery in both locally advanced, inoperable and primary operable mamma carcinomas. This, however, increases the rate of local relapse and the rate of mastectomy over the course of the disease, even although the EUSOMA guidelines are not exceeded. Whether the pre-surgical administration of chemotherapy with pathological complete remission actually increases the disease-free rate and overall survival remains to be determined. Further clinical studies are required to establish the reliability of sentinel lymph-node biopsy; currently, axillary lymphadenectomy is still the standard therapy. The response of the tumor to therapy, in correlation with predictive factors and the molecular-genetic profile, could make more individualized treatment regimes possible in the future.
authors.affiliation: Department of Obstetrics and Gynecology, University Medicine Berlin, Charité Campus Mitte, Berlin, Germany. anke.thomas@charite.de
authors.forename: Anke
authors.initials: A
authors.lastname: Thomas
authors.forename: Ralf
authors.initials: R
authors.lastname: Ohlinger
authors.forename: Maik
authors.initials: M
authors.lastname: Hauschild
authors.forename: Alexander
authors.initials: A
authors.lastname: Mustea
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Blohmer
authors.forename: Sherko
authors.initials: S
authors.lastname: Kümmel
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D011300:Preoperative Care / Q000379:methods