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Review
. 2021 Apr 21;11(5):324.
doi: 10.3390/jpm11050324.

Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes

Alba Di Leone  1 , Daniela Terribile  1 , Stefano Magno  1 , Alejandro Martin Sanchez  1 , Lorenzo Scardina  1 , Elena Jane Mason  1 , Sabatino D'Archi  1 , Claudia Maggiore  2 , Cristina Rossi  2 , Annalisa Di Micco  2 , Stefania Carnevale  3 , Ida Paris  4 , Fabio Marazzi  5 , Valeria Masiello  5 , Armando Orlandi  6 , Antonella Palazzo  6 , Alessandra Fabi  7 , Riccardo Masetti  1 , Gianluca Franceschini  1
Affiliations
Review

Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes

Alba Di Leone et al. J Pers Med. .

Abstract

Neoadjuvant chemotherapy is increasingly being employed in the management of breast cancer patients. Efforts and resources have been devoted over the years to the search for an optimal strategy that can improve outcomes in the neoadjuvant setting. Today, a multidisciplinary approach with the application of evidence-based medicine is considered the gold standard for the improvement of oncological results and patient satisfaction. However, several clinical complications and psychological issues due to various factors can arise during neoadjuvant therapy and undermine outcomes. To ensure that health care needs are adequately addressed, clinicians must consider that women with breast cancer have a high risk of developing "unmet needs" during treatment, and often require a clinical intervention or additional care resources to limit possible complications and psychological issues that can occur during neoadjuvant treatment. This work describes a multidisciplinary model developed at "Fondazione Policlinico Universitario Agostino Gemelli" (FPG) in Rome in an effort to optimize treatment, ease the application of evidence-based medicine, and improve patient quality of life in the neoadjuvant setting. In developing our model, our main goal was to adequately meet patient needs while preventing high levels of distress.

Keywords: breast cancer; evidence-based medicine; multidisciplinary treatment; neoadjuvant chemotherapy; oncological outcomes; patient quality of life; personalized treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Decision-making process for neoadjuvant chemotherapy [4].
Figure 2
Figure 2
Evidence-based medicine in neoadjuvant chemotherapy.
Figure 3
Figure 3
The neoadjuvant oncologic treatment team.
Figure 4
Figure 4
Frontal (a) and lateral (b) view of pre-neoadjuvant chemotherapy (NAC) breast with tumor projection and measurement (cm).
Figure 5
Figure 5
The neoadjuvant supportive care team.
Figure 6
Figure 6
Psychological interview.
See this image and copyright information in PMC

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