First, what is preoperative chemotherapy?
Chemotherapy is one of the important means of breast cancer treatment. Chemotherapeutic drugs enter the body through intravenous infusion and oral administration, and reach all parts of the body (especially tumor sites) through blood circulation to inhibit and kill tumor cells, so as to achieve the purpose of treating tumors.
Preoperative Chemotherapy Chemotherapy for breast cancer patients before surgery is also known as “neoadjuvant chemotherapy”.
Its purpose is to:
Reduce staging and strive for more surgical opportunities;
Reduce the difficulty of operation, reduce intraoperative metastasis and complications;
Eliminate micrometastasis and improve the long-term therapeutic effect;
By measuring the size changes of tumors during treatment, we can judge whether the current treatment is effective for tumors and observe the sensitivity of drugs to guide the follow-up treatment.
Therefore, the number of patients receiving preoperative chemotherapy is increasing year by year, and its status is gradually improving, which reflects the role of this treatment in screening high-risk groups, monitoring drug sensitivity and guiding follow-up treatment.
Second, which groups are suitable for preoperative neoadjuvant chemotherapy?
The first type of patients with large tumors, late staging, direct surgery can not ensure that the tumor is completely removed, and the operation is more difficult.
For these patients, preoperative neoadjuvant chemotherapy can reduce the size of the tumor, reduce the difficulty of staging and surgery, and ultimately remove the entire tumor safely and effectively.
The second part is patients who can strive for the opportunity of breast-conserving surgery.
With the development of medicine, the survival time of breast cancer patients is getting longer and longer, more and more patients pay more attention to the quality of life, and hope to maintain the beauty of the breast during surgery, breast-conserving surgery.
Some patients can not directly undergo breast-conserving surgery because of their large tumors, so preoperative neoadjuvant chemotherapy can be used to reduce or even disappear the tumors, so as to strive for the opportunity of breast-conserving surgery and achieve the goal of safety and beauty.
The third category is patients with partial triple negative or HER2 positive.
Patients
with triple-negative or HER2-positive breast cancer with higher malignancy, larger tumors or axillary lymph node metastasis can undergo preoperative neoadjuvant therapy, and then undergo surgery after a full course of preoperative treatment.
If the pathological results
after operation suggest that:
Pathological complete remission
has been achieved, which can significantly improve the long-term survival of patients.
If pathological complete remission
is not achieved, intensive treatment can be given after operation to improve the survival prognosis.
Three, after preoperative chemotherapy, do you still need surgery?
Once
a patient starts neoadjuvant chemotherapy, we monitor the size of the tumor regularly, and in general, the doctor will evaluate the efficacy every two cycles.
If the tumor shrinks, all planned neoadjuvant therapy should be completed. Generally, the cycle of neoadjuvant chemotherapy is 4-6 cycles, or even 8 cycles.
During this period, the patient should cooperate with the treatment and should not urge the doctor to perform the operation.
