The impact of neoadjuvant polychemotherapy on the feasibility of organ-preserving treatment in patients with triple-negative breast cancer

Background. Modern neoadjuvant polychemotherapy regimens have significantly increased the rate of objective tumor response in breast cancer, especially in aggressive subtypes such as triple-negative breast cancer (TNBC). Achieving a complete clinical and pathological response after neoadjuvant polychemotherapy expands the possibilities for breast-conserving surgery in patients who would previously have required mastectomy. Aim. To evaluate the effectiveness of neoadjuvant systemic therapy in patients with TNBC and to analyze surgical outcomes depending on the degree of tumor response to treatment. Materials and methods. The study included 210 patients with TNBC who underwent combined or comprehensive treatment at the Oncological Center No. 1, S. S. Yudin City Clinical Hospital, Moscow Healthcare Department, from 2020 to January 2025. At the first stage, all patients received neoadjuvant systemic therapy in accordance with current international and national standards; at the second stage, surgical treatment was performed. The evaluation criteria included the frequency of clinical and pathological responses, types and volumes of surgical interventions, and the proportion of breast-conserving surgeries. Results. Following neoadjuvant polychemotherapy, a complete clinical response was achieved in a significant proportion of patients; the rate of pathological complete response corresponded to international data for TNBC. The increase in pathological complete response frequency led to a higher proportion of breast-conserving procedures compared with initial surgical indications. The use of oncoplastic techniques and intraoperative assessment methods contributed to optimizing surgical radicality and improving aesthetic outcomes. Conclusion. Neoadjuvant systemic therapy in patients with TNBC increases the likelihood of achieving a complete tumor response and expands the indications for organ-preserving surgery. The application of oncoplastic approaches ensures oncological safety and favorable aesthetic results, thereby improving patients’ quality of life.