Is neoadjuvant therapy necessary for my aunt’s TNBC at 42?

Question

Hello doctor,

I have a question about something I heard recently. My aunt was just diagnosed with triple-negative breast cancer, and they mentioned starting with something called neoadjuvant therapy.

I am trying to understand- what exactly is that?
Is that where they start treatment before surgery? I ask because a colleague at work had breast cancer too, but she had surgery first, and then the other treatments came after.
It has got me a bit confused, and I want to make sure we are on the right track with my aunt’s care. Does neoadjuvant therapy help in a different way or something? Just trying to wrap my head around it all.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am sorry to hear about your aunt's diagnosis. To answer your question, yes, you are on the right track about neoadjuvant therapy. It refers to treatment that is given before surgery for cancer. The goal of neoadjuvant therapy, particularly for triple-negative breast cancer (TNBC), is to shrink the tumor before surgery, which can make it easier to remove and may even allow for breast-conserving surgery instead of a mastectomy.

In your aunt's case, with TNBC, neoadjuvant therapy often involves chemotherapy. TNBC is known to be more aggressive than other breast cancer subtypes, and chemotherapy tends to be very effective against it. The idea behind starting with this treatment is to not only reduce the size of the tumor but also to assess how well the cancer responds to the therapy.

If the tumor shrinks or even disappears on imaging, it is a good sign that the cancer is sensitive to the chemo. This can provide important information for further treatment decisions after surgery.

In contrast, adjuvant therapy is what your colleague likely received - surgery first, followed by chemotherapy, radiation, or hormone therapy to eliminate any remaining cancer cells and reduce the risk of recurrence.

The choice between neoadjuvant and adjuvant therapy can depend on several factors, including the size and location of the tumor, lymph node involvement, and the biological characteristics of the cancer (like whether it's triple-negative).

To sum up, neoadjuvant therapy helps by:

Shrinking the tumor before surgery.
Possibly allowing less extensive surgery.
Giving an early indication of how well the cancer responds to treatment.

It is a standard and effective approach for certain aggressive cancers like TNBC, so your aunt’s care seems to be right in line with current medical practices.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.