Primary endocrine and chemotherapeutic treatment of breast cancer

Primary chemotherapy ploys on established role in the treatment of locally advanced breast cancer. However, uncertainties remain: Both, the role of new agents, such as paclitaxel and docetaxel, and the most effective protocols of application are still being evaluated. Valid predictive factors for primary chemotherapy need yet to be defined. Pilot studies on primary endocrine treatment of breast cancer indicate a promising new therapeutic modality, which is currently, however, still highly experimental. The following review will try to define the current status of primary systemic breast cancer therapy as well as the remaining controversies. It includes the presentation of current trials which will hopefully help us solve these problems in the years to come.