Postneoadjuvant treatment of breast cancer

The treatment of early breast cancer is individualized based on the tumor biology, tumor stage, and individual factors. Medication-based treatment can be conducted as primary systemic treatment before or as adjuvant therapy after completing local treatment. Primary systemic treatment follows a two-step concept: based on the result of the postoperative histopathological assessment, the subsequent postneoadjuvant treatment can be adjusted and the risk of recurrence can be reduced. The selection and combination of substances in the postneoadjuvant setting are carried out on an individual risk-adapted basis, whereby achieving pathological complete remission (pCR) is of significant importance in addition to the tumor biology, initial tumor stage and genetic risk. As the treatment options are complex, these decisions should be made individually in the interdisciplinary tumor board both preoperatively and postoperatively, also in coordination with local treatment.