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The Neoadjuvant Therapy for Breast Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 May 2025) | Viewed by 2190

Special Issue Editors


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Guest Editor
Gynecological Cancer Center, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
Interests: ovarian cancer; breast cancer; novel therapy; immune therapy; CTCs; breast cancer immunitherapy

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Guest Editor
Department of Medical Oncology, Institute of Oncology Ljubljana, Zaloska 2, SI-1000 Ljubljana, Slovenia
Interests: breast cancer; head and neck cancer; thyroid cancer; CTC; ctDNA; TIL

Special Issue Information

Dear Colleagues,

Neoadjuvant chemotherapy in breast cancer has emerged as a significant paradigm in redefining the approach to treatment planning and patient outcomes. This innovative therapeutic strategy involves administering chemotherapy before surgical intervention, a departure from its conventional post-surgery counterpart. Neoadjuvant chemotherapy offers several advantages, including the potential for tumor size reduction, facilitating less invasive surgical procedures, and providing an in vivo assessment of the tumor's response to treatment. This approach not only improves the chances of achieving complete pathological response but also enables the tailoring of subsequent treatment strategies based on the tumor's biological behavior during treatment. This Special Issue delves into the rationale, benefits, challenges, and recent advancements surrounding neoadjuvant chemotherapy in breast cancer, highlighting its transformative role in optimizing patient care and enhancing the overall management of this prevalent malignancy. We invite all interested authors to contribute their work concerning breast cancer, neoadjuvant treatment, outcome studies, and molecular treatments.

We look forward to receiving your contributions.

Dr. Marcus Vetter
Dr. Cvetka Grašič-Kuhar
Guest Editors

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Keywords

  • breast cancer
  • neoadjuvant treatment
  • innovative therapy
  • outcome studies
  • molecular treatments

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Published Papers (2 papers)

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Research

12 pages, 1168 KiB  
Article
Using [18F]FDG PET/CT to Identify Optimal Responders to Neoadjuvant Therapy in Breast Cancer—Results from a Prospective Patient Cohort
by Fabrizia Gelardi, Paola Tiberio, Rosalba Torrisi, Roberta Zanca, Marcello Rodari, Alberto Zambelli, Armando Santoro, Bethania Fernandes, Andrea Sagona, Valentina Errico, Alberto Testori, Corrado Tinterri, Arturo Chiti, Rita De Sanctis, Martina Sollini and Lidija Antunovic
Cancers 2025, 17(13), 2133; https://doi.org/10.3390/cancers17132133 - 25 Jun 2025
Abstract
Background/objectives: Pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer (BC) is a solid indicator of favourable prognosis, potentially also being useful for more conservative patient management. We aim to explore the potential of [18F]FDG PET/CT as a [...] Read more.
Background/objectives: Pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer (BC) is a solid indicator of favourable prognosis, potentially also being useful for more conservative patient management. We aim to explore the potential of [18F]FDG PET/CT as a non-invasive method to predict response to NAC. Methods: In this prospective, observational cohort study, we enrolled BC patient candidates for NAC who underwent baseline and preoperative [18F]FDG PET/CT. NAC response was determined using final histopathology. PET images were assessed qualitatively and semi-quantitatively, and the findings correlated with NAC response. Results: In total, 133 BC patients were included. The visual analysis of preoperative PET/CT detected residual disease (RD) with high specificity (>93%) and moderate sensitivity, based on pCR/RD classification and RCB index. Semiquantitative measures (SUVmax, TBR) were significantly higher in non-responders across the classification methods (p < 0.001 for all). Conclusions: These findings highlight the potential of preoperative [18F]FDG PET/CT as a complementary tool for identifying excellent responders to NAC across BC subtypes or response criteria. This could inform personalised treatment and potentially allow for surgery to be omitted in selected patients. Full article
(This article belongs to the Special Issue The Neoadjuvant Therapy for Breast Cancer)
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15 pages, 936 KiB  
Article
Prognostic Importance of Axillary Lymph Node Response to Neoadjuvant Systemic Therapy on Axillary Surgery in Breast Cancer—A Single Center Experience
by Cvetka Grašič Kuhar, James Geiger, Fabienne Dominique Schwab, Viola Heinzelmann-Schwartz, Marcus Vetter, Walter Paul Weber and Christian Kurzeder
Cancers 2024, 16(7), 1306; https://doi.org/10.3390/cancers16071306 - 27 Mar 2024
Cited by 3 | Viewed by 1680
Abstract
Neoadjuvant systemic treatment (NST) is the standard treatment for HER2+, triple-negative (TN), and highly proliferative luminal HER2− early breast cancer. Pathologic complete response (pCR) after NST is associated with improved outcomes. We evaluated the predictive factors for axillary-pCR (AXpCR) and its impact on [...] Read more.
Neoadjuvant systemic treatment (NST) is the standard treatment for HER2+, triple-negative (TN), and highly proliferative luminal HER2− early breast cancer. Pathologic complete response (pCR) after NST is associated with improved outcomes. We evaluated the predictive factors for axillary-pCR (AXpCR) and its impact on the extent of axillary node surgery. This retrospective study included 92 patients (median age of 50.4 years) with an initially node-positive disease. Patients were treated with molecular subtype-specific NST (4.3% were luminal A-like, 28.3% luminal HER2−, 26.1% luminal HER2+, 18.5% HER2+ non-luminal, and 22.8% TN). Axillary-, breast- and total-pCR were achieved in 52.2%, 48.9%, and 38% of patients, respectively. In a binary logistic regression model for the whole population, the only independent factor significantly associated with AXpCR was breast-pCR (OR 7.4; 95% CI 2.6–20.9; p < 0.001). In patients who achieved breast-pCR, aggressive subtypes (HER2+ and TN; OR 11.24) and clinical tumor stage (OR 0.10) had a significant impact on achieving AXpCR. Axillary lymph node dissection was avoided in 53.3% of patients. In conclusion, in node-positive patients with HER2+ and TN subtypes, who achieved breast-pCR after NST, de-escalation of axillary surgery could be considered in most cases. Full article
(This article belongs to the Special Issue The Neoadjuvant Therapy for Breast Cancer)
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