This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.
Introduction: Some women with stage II or stage III breast cancer may get chemotherapy before breast surgery (called neoadjuvant chemotherapy). Neoadjuvant chemotherapy can shrink tumors such that a lumpectomy (breast-conserving surgery) becomes an option to a mastectomy.
Learn more about neoadjuvant chemotherapy.
For women with HER2-positive breast cancer, neoadjuvant trastuzumab (Herceptin) may be added to neoadjuvant chemotherapy [1-3].
Learn more about trastuzumab (Herceptin).
Learn about the strengths and weaknesses of different types of studies.
Study selection criteria: Randomized controlled trials with at least 100 participants and meta-analyses.
Table note: These studies looked at different chemotherapy drug regimens, so results cannot be compared directly to one another. However, for each study, the neoadjuvant and adjuvant chemotherapy drug regimens are the same.
Study Population(number of participants)
Stage of Breast Cancer
Median Follow-up (years)
Chemotherapy Drug Regimen
Survival and Rate of Lumpectomy with Neoadjuvant Chemotherapy
Randomized controlled trials
NSABP B-18 
T1-T3, N0-N1, M0
Overall survival at 9 years:69% with neoadjuvant therapyvs.70% with adjuvant therapy
Disease-free survival at 9 years: 55% with neoadjuvant therapyvs. 53% with adjuvant therapy
Percentage of women with planned mastectomy who had lumpectomy instead: 16%
Gianni et al. 
T2-T3, N0-N1, M0
Doxorubicin, cyclophosphamide, methotrexate, 5-fluorouracil, paclitaxel
Disease-free survival at 6 years:No difference between the two groups
Overall survival at 6 years:No difference between the two groups
van der Hage et al. 
T1c, T2, T3, T4b, N0-N1, M0
Fluorouracil, epirubicin, cyclophosphamide
Overall survival at 4 years: 82% with neoadjuvant therapyvs.84% with adjuvant therapy
Progression-free survival at 4 years: 65% with neoadjuvant therapyvs.70% with adjuvant therapy
Percentage of women with planned mastectomy who had lumpectomy instead: 23%
Broët et al. 
390 premenopausal women
Cyclophosphamide, doxorubicin, and 5-fluorouracil
Overall survival at 10 years: 65% with neoadjuvant therapyvs.60% with adjuvant therapy
Mauriac et al. 
T2 larger than 3 cm or
T3, N0-1, M0
Epirubicin, vincristine, methotrexate, mitomycin, thiotepa, vindesine
Overall survival at 10 years: No difference between the two groups
Gazet et al. 
T1-T4, N0, N1-N2
Estrogen receptor-positive cancers: hormone therapy
Estrogen receptor-negative cancers: mitozantrone, mitomycin, methotrexate
Premenopausal cancers: goserelin
Postmenopausal cancers: formestane
Overall survival at 5 years:79% with neoadjuvant therapyvs. 87% with adjuvant therapy
Disease-free survival at 5 years: No difference between the two groups
Lumpectomy rate: 60% had a less invasive surgery with neoadjuvant therapy
Mieog et al. 
Overall survival:No difference between the two groups Recurrence: No difference between the two groups Lumpectomy rate:26% had a less invasive surgery with neoadjuvant therapy
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