Neo-adjuvant treatments are those given before surgery and include chemotherapy and endocrine therapy (hormone blocking tablets). Chemotherapy tends to be offered to younger women and endocrine therapy to older women. Endocrine therapy can only be given if your cancer is sensitive to hormones.
We may suggest neo-adjuvant treatment if a breast cancer is large compared to the size of your breast; treatment to make it smaller before surgery may allow you to have breast conserving surgery instead of a mastectomy.
Another reason to recommend neo-adjuvant treatment is if there maybe a gene alteration in your family, for instance if you are young and develop breast cancer and there are other family members affected. If you find that you are carrying a gene alteration that would make you more likely to get breast cancer again in the future you may decide to have mastectomies rather than keeping breast tissue. Genetic testing takes some months, and having neo-adjuvant treatment allows you to time to have this done before you need to make decisions about surgery.
Sometimes hormone blocking tablets are used (endocrine therapy) if you are unable to have surgery straight away, for instance if you are getting over another illness or if you have other commitments. Your Doctor and Breast Care Nurse will discuss with you if you are suitable for this form of treatment.
Having neo-adjuvant treatment is perfectly safe and the whole of your body is being treated at once. Many studies have been done and have shown that the overall outcomes are as good with neo-adjuvant treatment first as with surgery first.
If you have neo-adjuvant treatment you will be closely monitored, either in an Oncology or Surgery clinic. We will be able to see that the treatment is working by examining you and doing scans, and can change to different treatments or recommend surgery if we aren’t seeing the cancer getting smaller. We will discuss all of these decisions with you.