Letter to the Editor/Response

Abstract

Neo-adjuvant chemotherapy has been widely used for breast cancer treatment due to the effective pathologic responses seen with newer therapeutic agents. 2 Recently, it has also been introduced for the treatment of early breast cancer. 3 Despite this, there is ongoing debate and controversies related to the use of neo-adjuvant chemotherapy in breast cancer (critically appraised in a recent review by Vaidya et al 2 ).We find Dr Altundag's point regarding our neo-adjuvant cohort quite valid. In our study, ~43% of patients with invasive apocrine carcinoma (IAC) presented at the advanced stage (III or IV) with only 19% of the patients having the tumor size ≤2 cm at presentation. This is mainly due to the lack of organized screening program at the national level. In this regard, our small IAC cohort treated in neo-adjuvant setting is somehow biased but it essentially reflected the previous and current overall breast cancer presentation in Bosnia and Herzegovina. Consequently, the response rates to neo-adjuvant therapy in our study may be different from the previously published data. Noteworthy, IAC is a rare breast cancer subtype (~1%-2% of all breast cancers) 4,5 and future larger and multi-institutional studies are required to validate the effectiveness of (neo)adjuvant chemotherapy in patients with IAC. O RCI D Semir Vranichttps://orcid.org/0000-0001-9743-7265 R E FE R E N C E S1. Imamovic D, Bilalovic N, Skenderi F, et al. A clinicopathologic study of invasive apocrine carcinoma of the breast: a single-center experience. Breast J. 2018;24(6):1105-1108. 2. Vaidya JS, Massarut S, Vaidya HJ, et al. Rethinking neoadjuvant chemotherapy for breast cancer. BMJ. 2018;360:j5913. 3. Cain H, Macpherson IR, Beresford M, Pinder SE, Pong J, Dixon JM. Neoadjuvant therapy in early breast cancer: treatment considerations and common debates in practice. Clin Oncol (R Coll Radiol).