Neoadjuvant chemotherapy in breast cancer: more than just downsizing

The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) has established a new milestone in evidence-based treatment for early breast cancer. Through longstanding collaboration, mutual trust, and data transparency, they have gathered individual patient data for 4756 women randomly allocated in ten trials to either neoadjuvant chemotherapy (NACT) or adjuvant chemotherapy, with a median follow-up of 9 years (IQR 5–14). The results of this meta-analysis,1 published in The Lancet Oncology, substantiate that NACT results in higher rates of breast-conserving therapy than does adjuvant chemotherapy (rate ratio 1·28 [95% CI 1·22–1·34]), without compromising on distant recurrence, breast cancer survival, or overall survival.