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Conundrum of PST: current evidence
Fisher B, et al. JCO 1997;15:2483-93 - Bear HD, et al JCO 2003;21:4165-74.
NSABP-B18
NSABP-B27
Conclusions:
Overall:
✓
Equal survival when the same regimen is given
before or after Sx
✓
Fewer mastectomies
Specific:
✓
Better survival for patients with a pCR after PST
✓
Addition of taxanes
✓
Increased pCR
✓
No improvement in survival
✓
No increased BCT rate