What is neoadjuvant chemotherapy for breast cancer?

One of the principles of adjuvant chemotherapy for breast cancer is to start adjuvant chemotherapy as early as possible after surgery. This type of adjuvant chemotherapy, which is given early after surgery, is called early adjuvant chemotherapy for breast cancer. It is generally believed that it should be started within 2 weeks after surgery, and if there are no special circumstances, it should not be more than 4 weeks after surgery at the latest, which has been confirmed in breast cancer and colorectal cancer.

In recent years, some foreign scholars have started early adjuvant chemotherapy after surgery on the first day after surgery, and there have been no more complications, and the long-term efficacy needs to be further tracked and observed. At present, some scholars believe that the timing of chemotherapy should be as early as possible, even before surgery. This method of preoperative chemotherapy, which is administered earlier than surgery, is called "neoadjuvant chemotherapy".

Neoadjuvant chemotherapy is a new development of a comprehensive strategy for breast cancer, which has a certain theoretical basis and scientific basis, and clinical practice has also proved that it is beneficial to breast cancer, so it has been more and more recognized and widely used in clinical practice. The main advantages of the neoadjuvant chemotherapy approach are as follows.

1) Control the primary lesion, maximize the shrinkage of advanced tumors, and reduce the clinical stage so that surgical resection or radiotherapy can be achieved.

2) Control of micrometastatic lesions, cancer is often not a local disease, and the application of surgery** or a combination of surgery + radiotherapy ** can delay the whole body** for 1 4 months.

Experiments have shown that this delay will increase the risk of tumors developing resistance to drugs. Because of the microscopically visible tumor burden, an increase of 5 doubling times or less than 2 logarithmic increases the risk of developing drug-resistant mutant cells5 95.

Chemotherapy after surgery is called adjuvant chemotherapy, and chemotherapy before surgery is called neoadjuvant chemotherapy. In the past, surgery was generally the first choice for breast cancer, followed by chemotherapy, but nowadays, chemotherapy followed by surgery is also common.

If the tumor is too large, chemotherapy can be used to shrink the tumor and surgery is an option. For patients whose tumors are small but are not eligible for breast-conserving surgery, chemotherapy can downstage the tumor. Downstaging refers to the shrinkage or even disappearance of the tumor after chemotherapy, reducing the stage at the time of diagnosis.

Some experts believe that tumor cells become inactive after surgery, and that preoperative chemotherapy can kill active tumor cells directly. Preoperative chemotherapy, if the tumor shrinks, it means that the tumor is effective against this drug and can be continued to be used to avoid ineffectiveness due to the wrong drug after surgery.

Neoadjuvant chemotherapy for breast cancer refers to chemotherapy given before surgery, also known as "preoperative**". The so-called neoadjuvant chemotherapy is relative to adjuvant, and traditional adjuvant chemotherapy is administered after surgery, and neoadjuvant chemotherapy needs to be given before surgery.

You can do surgery directly, or conservative**, you can also do endocrine drugs**, or radiotherapy, you can also do targeted drugs**, **There are many means.

Methods that can be used for breast cancer, including radiotherapy, surgery, endocrine drugs, targeted drugs, and conservative, can alleviate the pain.

**The means include surgery, radiotherapy, chemotherapy, endocrine**, targeting**, and the fastest method is surgery**.

Patients may experience fatigue, malaise, sweating, and drowsiness. Chemotherapy drugs can damage a person's immune system, leading to a deficiency or decline in immune function. Most chemotherapy drugs can cause bone marrow suppression, which is manifested by a decrease in white blood cells and platelets, even a decrease in red blood cells, hemoglobin, etc., and hair loss, nausea, etc.

It is recommended to take Tihengjian Selenium Weikang Chewable Tablets during the interval between tumor radiotherapy and chemotherapy, which will help patients better tolerate the toxic and side effects of radiotherapy and chemotherapy, enhance the ability to resist tumors, and improve the comprehensive effect of malignant tumors.

Chemotherapy is not a good way to prolong the life of those who are at an advanced stage**, and early breast cancer should be treated with surgery**.

Breast cancer is very scary, and it is recommended that you go to the hospital for careful quality.

Breast cancer in general is a lot of means, so at present we are talking about the synthesis of breast cancer, the synthesis of breast cancer includes breast cancer, a surgery, breast cancer radiotherapy, breast cancer chemotherapy, breast cancer targeting, of course, also includes our traditional Chinese medicine, breast cancer surgery**is breast cancer, a very important link, we have a saying, there are conditions to go on without conditions to create conditions, that is, surgery, then breast, Other ** also includes, chemotherapy for breast cancer, chemotherapy for breast cancer, he is a means of the whole body, it uses cytotoxic drugs to directly kill tumor cells, then it is actually unable to distinguish between good cells and bad cells, so while killing tumor cells, it will also have an impact on normal cells, so many patients in the process of chemotherapy, due to the damage to normal cells, there will be vomiting.

Hair loss, low blood cells, and other adverse reactions, then there is another ** is radiotherapy, radiotherapy and breast cancer surgery**, both belong to the local **, then it is the use of radiation in the local area of irradiation to reduce the risk of breast cancer local **, can also bring patients distant survival, etc., some benefits, there is some endocrine **, then not all breast cancer patients, are suitable for endocrine**, only estrogen receptor or progesterone, Receptor-positive patients, acceptable endocrine**, and a target**, then we say that we have now entered an era of precision, so targeting** actually reflects the meaning of this precision**, which is currently relatively mature.

The widely used targeting** is aimed at a target like HER2, so for HER2-positive breast cancer, the application of targeted ** can bring survival benefits to others can be increased by 30% to 40%, it is a milestone leap, so finally, there is our Chinese medicine **, the Chinese medicine is a full participation in the whole process of breast cancer, then it can improve the recovery of breast cancer patients after breast cancer surgery, a perioperative period, It can alleviate the toxicity and side effects of radiotherapy and chemotherapy, so it can improve the patient's survival expectation, so the best method of traditional Chinese medicine is also very important.

Neoadjuvant chemotherapy refers to systemic chemotherapy done before the implementation of local methods (such as surgery or radiotherapy), with the aim of shrinking the mass and killing invisible metastatic cells as soon as possible, so as to facilitate subsequent surgery, radiotherapy, etc. For patients with early-stage tumors, patency can be done through local **regimen**, and neoadjuvant chemotherapy is not required. For patients with advanced tumors, neoadjuvant chemotherapy is usually not used because they have lost the opportunity of ** tumor.

Commonly used chemotherapy regimens for breast cancer:

1- CMF protocol (transfer).

ctx 600mg/m2 d1; mtx 40mg/m2 day 1and 8;5fu 600mg/m2day 1and 8;Repeat every 21 days 6 adjuvant chemotherapy for commonly resectable breast cancer.

2- CAF scheme

ctx 500mg/m2 day 1;adm 50mg/m2 day 1; 5fu 500mg/m2 day 1； 40-65%。This regimen is currently the most recommended chemotherapy regimen for breast cancer surgery. It has been suggested that the results of the 4 courses of the CAF regimen are the same as the 6 courses of the CMF regimen.

3-FAC scheme

5FU 500mg M2, D1 and D8 rest with CAF regimen. CMF regimen (postoperative standard adjuvant chemotherapy): CTX 100mg M2 orally for 1-14 days; MTX 40mg m2 IV day 1-8 days; 5fu 600mg m2 iv day 1 and 8 days; Repeat every 4 weeks for 6 cycles.

4- AC scheme

ctx 600mg/m2 day 1 adm 60mg/m2 iv day 1;Repeat every 3 weeks. At the 2004 CSCO Annual Meeting, it was reported that doxorubicin doses above 60 mg m2 did not improve the efficacy of chemotherapy. The addition of Tysol 175 mg M2 to the traditional AC chemotherapy regimen in the adjuvant breast cancer has been well established.

5- CAP scheme

ctx 500mg/m2 day 1 and 8; adm 40mg/m2 iv day 1; ddp 50mg/m2 iv d3 and d8；

6- MCF protocol

mmc 20mg iv d1; ctx 1000mg iv d1;5fu iv gtt qd for 5 days. (I used it for advanced breast cancer and the effect is very good).

7- MVD scheme

mmc 8mg/m2 d1 + vds 3mg d1 and d8；DDP 30mg M2 IV GTT qd for 3 days.