title: Neoadjuvant chemotherapy for operable breast cancer.
abstract: BACKGROUND
  Neoadjuvant chemotherapy for early breast cancer can avoid mastectomy by shrinkage of tumour volume. This review assesses the effectiveness of neoadjuvant chemotherapy on clinical outcome.
  
  
  METHODS
  All randomized trials comparing neoadjuvant and adjuvant chemotherapy for early breast cancer were reviewed systematically and meta-analyses were performed.
  
  
  RESULTS
  Fourteen studies randomizing 5500 women were eligible for analysis. Overall survival was equivalent in both groups. In the neoadjuvant group, the mastectomy rate was lower (relative risk 0.71 (95 per cent confidence interval (c.i.) 0.67 to 0.75)) without hampering local control (hazard ratio 1.12 (95 per cent c.i. 0.92 to 1.37)). Neoadjuvant chemotherapy was associated fewer adverse effects.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy is an established treatment option for early breast cancer.
authors: Department of Surgery, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands.
authors: J S D
authors: JS
authors: Mieog
authors: J A
authors: JA
authors: van der Hage
authors: C J H
authors: CJ
authors: van de Velde
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents