If breast cancer is not amenable to surgery first, then neoadjuvant therapy should be performed, where the indications for neoadjuvant therapy, according to the guidelines, are preoperative neoadjuvant drug therapy if one of the following conditions is met:
- Large mass (>5 cm);
- Metastasis in axillary lymph nodes;
- HER-2 positive;
- Triple-negative breast cancer;
- Those who have the desire to preserve breast, but the tumor size is large in proportion to the breast volume, making it difficult to preserve breast.
Most Chinese experts believe that when using only HER-2 positive or triple negative as a criterion for preoperative neoadjuvant drug therapy selection for breast cancer, the tumor should be larger than 2 cm or can be added to clinical studies. Other than these factors, the rest of the breast tumors are treated surgically when possible with early detection.