Surgery after primary systemic chemotherapy in patients with breast cancer

Application of systemic therapy in curable breast cancer for the purpose of a 'neoadjuvant' or rather a primary systemic therapy (PST) prior to surgery is increasingly preferred. There are considerable advantages concerning this concept of treatment for both clinical and scientific reasons. An increasing rate of breast conserving therapies has top priority for the affected patients. There is also a notable positive psychological effect for the patients caused by the shrinkage of the tumor as a consequence of a therapy-achieved positive tumor response. Nevertheless, physicians are faced with the challenge of PST and its achieved effects on the tissue. They occur especially as patients undergo therapy as well as during and after surgery.