The evolution of primary chemotherapy in breast cancer treatment

Tadashi Ikeda, Hiromitsu Jinno, Masaki Kitajima

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)


Primary chemotherapy may be thought of as having evolved over three generations. First-generation primary chemotherapy followed trials which proved that the prognosis of breast cancer patients receiving primary chemotherapy was the same as that of patients receiving post-operative chemotherapy. Secondgeneration primary chemotherapy followed trials which demonstrated that regimens containing anthracyclines and taxanes yielded complete pathological response rates (pCR) of over 20%. Third-generation primary chemotherapy followed trials which demonstrated that inclusion of newer agents, such as trastuzumab and capetitabine, in combination with taxanes could yield pathological CR rates of over 30%. In third-generation primary chemotherapy, predictive factors, especially those analyzed by DNA array analysis, play a key role. Other issues, including the relevance of sentinel node biopsy after primary chemotherapy and the importance of marking the site of the primary tumor before primary chemotherapy in cases showing cCR, are highlighted. This article deals with the history of the evolution of primary chemotherapy, along with a discussion of some relevant issues.

Original languageEnglish
Pages (from-to)148-155
Number of pages8
JournalBreast Cancer
Issue number2
Publication statusPublished - 2004 Apr
Externally publishedYes


  • Breast Cancer
  • Neoadjuvant chemotherapy
  • Preoperative chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)


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