关键词: 乳腺癌, 新辅助化疗, 保乳手术, 个体化治疗, 规范化治疗

Abstract: Concerns about breast conserving surgery after neoadjuvant chemotherapy        LIU Zhen-yu, FAN Zhi-min.Department of Breast Surgery, the First Bethune Hospital of Jilin University, Changchun 130021, China
Corresponding author：FAN Zhi-min, E-mail: fanzm@jlu.edu.cn 
Abstract    The purpose of neoadjuvant chemotherapy has gradually expanded from the initial stage of locally advanced breast cancer downgrading to the detection of tumor drug sensitivity and speeding up the approval of drugs based on the short-term efficacy of clinical trials. One of the benefits of tumor downstaging is to make breast conserving surgery (BCS) possible for LABC patients. Individualized neoadjuvant chemotherapy based on tumor stage, molecular typing and other factors has gradually improved the curative effect. In recent years, the combination of chemotherapeutic drugs and targeted drugs or immunotherapy has made more HER-2 positive and triple negative breast cancer patients achieve satisfactory curative effects, so that breast conserving surgery can be possible after neoadjuvant chemotherapy.However, there are many differences between BCS in the adjuvant and neoadjuvant settings. The success of breast conserving surgery after neoadjuvant chemotherapy usually depends on obtaining accurate imaging information, clinical and pathological features, accurate positioning and labeling of tumors before neoadjuvant therapy, and understanding the tumor regression mode and accurate repositioning of expected resected lesions by reviewing the data before neoadjuvant chemotherapy. On the premise of R0 resection, postoperative radiotherapy and good cosmetic effect, breast conserving surgery is safe and feasible for patients in descending stage after neoadjuvant chemotherapy.

Key words: breast cancer, neoadjuvant chemotherapy, breast-conserving surgery, tailored treatment, standardized treatment