Adjuvant and neoadjuvant chemotherapy of breast cancer

Adjuvant treatment modalities have significantly improved the prognosis of early breast cancer. Neoadjuvant systemic therapy is recommended in patients with locally advanced, inoperable or inflammatory breast cancer and is increasingly being used in patients with high-risk operable primary breast cancer. Evaluation of adjuvant and neoadjuvant treatment regimens for different patient subgroups as well as the results of current clinical studies. Interpretation of current evidence on adjuvant and neoadjuvant therapy, review of treatment recommendations and current study concepts. Adjuvant and neoadjuvant chemotherapy with anthracyclines, cyclophosphamide and taxanes are equally effective regarding survival. There is a correlation between the achievement of pathological complete response (pCR) and prolonged survival, especially in patients with hormone receptor-negative (after chemotherapy) and HER2-positive tumors (after chemotherapy and trastuzumab). For patients without pCR, the prognosis is less favorable and new postoperative therapies are necessary, mainly in prospective randomized trials. Dose-dense (neo)adjuvant chemotherapies are increasingly considered as preferred regimens. For patients without pCR, the prognosis is less favorable and new postoperative therapies are necessary, mainly in prospective randomized trials.