Features of surgical treatment of patients with breast cancer receiving preoperative systemic therapy

Preoperative systemic therapy of breast cancer is one of the most promising and rapidly developing areas of modern oncology. Effective preoperative systemic treatment modifies the subsequent surgical step, contributes to the elimination of subclinical micrometastases and carcinoma sensitivity assessment for this type of therapy. However, the main goal is to achieve complete morphological regression, as a predictor of favorable prognosis of the disease. The proportion of patients who achieved a complete tumor response to preoperative effective systemic therapy is steadily growing, which creates certain difficulties at all steps of surgical treatment due to loss of macroscopic tumor area. Placement of image-detectable marker into the primary tumor and assessment of the status of regional lymph nodes before the start of systemic therapy, preoperative demarcate the residual tumor, planning volume of removed tissue, evaluation of resection margins and clipping the tumor bed for adjuvant radiation therapy with boost is a continuous chain of modern multidisciplinary approach in the treatment of breast cancer, the need to implement in clinical practice becomes apparent.