Breast: Chemotherapy

Chemotherapy

Neoadjuvant Chemotherapy Indications

  • Locally Advanced Disease (T3-T4)
  • Earlier Disease (T1-T2) if Breast-Conserving Treatment (BCT) is Not Currently Possible Due to:
    • High Tumor-to-Breast Volume Ratio
    • Cosmetic Result Would Be Unacceptable Due to Location
  • Inflammatory Breast Cancer
  • Pregnancy (Second Trimester) to Delay Surgery Until After Delivery
  • May Also Consider for Clinically Node-Positive Disease

Adjuvant Chemotherapy Indications

  • Variable Indications
  • ≥ 3 Positive Lymph Nodes & Not Received Neoadjuvant Treatment
    • May Also Consider for 1-2 Positive Lymph Nodes
  • High Oncotype Dx 21-Gene Recurrence Score
    • Indicated for Scores ≥ 26
    • May Also Consider for Scores 16-25
  • Triple Negative (ER-/PR-/HER2-) Disease
  • HER-2 Positive Disease

Most Likely to Benefit

  • High-Grade
  • Lymph Node Positive
  • High S-Phase or Ki-67