If neoadjuvant chemotherapy is effective, what surgical option might be possible instead of mastectomy?

• A. Lumpectomy plus radiation therapy
• B. Total mastectomy with no reconstruction
• C. No surgery needed
• D. Lymph node dissection only

Answer: (A)

Neoadjuvant chemotherapy aims to shrink the tumor before surgery. If the response is strong, the tumor can become small enough to remove with breast-conserving surgery, such as a lumpectomy, rather than removing the entire breast. After the lumpectomy, radiation therapy is given to kill any remaining cancer cells and reduce the risk of local recurrence. This approach preserves more of the breast when the tumor responds well to treatment.

The other options aren’t as suitable in this scenario: removing the whole breast without reconstruction is more extensive than needed when the tumor can be adequately excised with conservation; no surgery is not typical because residual disease usually remains even after chemotherapy; and focusing only on lymph node dissection would leave the tumor in the breast and isn’t sufficient curative treatment.