Neoadjuvant chemotherapy for invasive breast cancer
This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.
Introduction: Some women with invasive breast cancer may get chemotherapy before breast surgery (called neoadjuvant chemotherapy).
Neoadjuvant chemotherapy may shrink tumors enough so a lumpectomy (breast-conserving surgery) becomes an option to a mastectomy.
Learn more about neoadjuvant chemotherapy.
Learn about the strengths and weaknesses of different types of studies.
Table note: These studies looked at different chemotherapy drug regimens, so results can’t be compared directly to one another. However, for each study, the neoadjuvant and adjuvant (after surgery) chemotherapy drug regimens are the same.
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:
Disease-free survival at 9 years:
Percentage of women with planned mastectomy who had lumpectomy instead:
Gianni et al. 
T2-T3, N0-N1, M0
Doxorubicin, cyclophosphamide, methotrexate, 5-fluorouracil, paclitaxel
Disease-free survival at 6 years:
Overall survival at 6 years:
van der Hage et al. 
T1c, T2, T3, T4b, N0-N1, M0
Fluorouracil, epirubicin, cyclophosphamide
Overall survival at 4 years:
Progression-free survival at 4 years:
Percentage of women with planned mastectomy who had lumpectomy instead: 23%
Golshan et al. 
Paclitaxel (with or without carboplatin and/or veliparib), doxorubicin and cyclophosphamide
Percentage of women with planned mastectomy who had the option of lumpectomy instead: 53%
Broët et al. 
390 premenopausal women
T2-T3, N0-N1, M0
Cyclophosphamide, doxorubicin, and 5-fluorouracil
Overall survival at 10 years:
Mauriac et al. 
T2 larger than 3 cm or
T3, N0-1, M0
Epirubicin, vincristine, methotrexate, mitomycin, thiotepa, vindesine
Overall survival at 10 years:
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:
Disease-free survival at 5 years:
Chen et al. 
Mieog et al. 
- Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr. (30):96-102, 2001.
- Gianni L, Baselga J, Eiermann W, et al. Phase III trial evaluating the addition of paclitaxel to doxorubicin followed by cyclophosphamide, methotrexate, and fluorouracil, as adjuvant or primary systemic therapy: European Cooperative Trial in Operable Breast Cancer. J Clin Oncol. 27(15):2474-81, 2009.
- van der Hage JA, van de Velde CJH, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 19(22):4224-37, 2001.
- Golshan M, Loibl S, Wong SM, et al. Breast conservation after neoadjuvant chemotherapy for triple-negative breast cancer: surgical results from the BrighTNess randomized clinical trial. JAMA Surg. 2020 Jan 8 [Epub ahead of print].
- Broët P, Scholl SM, de la Rochefordière A, et al. Short and long-term effects on survival in breast cancer patients treated by primary chemotherapy: an updated analysis of a randomized trial. Breast Cancer Res Treat. 58(2):151-6, 1999.
- Mauriac L, MacGrogan G, Avril A, et al. Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonie Bordeaux Groupe Sein (IBBGS). Ann Oncol. 10(1):47-52, 1999.
- Gazet JC, Ford HT, Gray R, et al. Estrogen-receptor-directed neoadjuvant therapy for breast cancer: results of a randomised trial using formestane and methotrexate, mitozantrone and mitomycin C (MMM) chemotherapy. Ann Oncol. 12(5):685-91, 2001.
- Chen Y, Shi XE, Tian JH, Yang XJ, Wang YF, Yang KH. Survival benefit of neoadjuvant chemotherapy for resectable breast cancer: A meta-analysis. Medicine (Baltimore). 97(20):e10634, 2018.
- Mieog JS, van der Hage JA, van de Velde CJ. Neoadjuvant chemotherapy for operable breast cancer. Br J Surg. 94(10):1189-200, 2007.