Table 1.

Evolution of neoadjuvant chemotherapy and endocrine therapy for patients with breast cancer

Era	Major goals	Outcome achieved?
Neoadjuvant chemotherapy
1980s	Improved uptake of breast-conserving surgery	Yes
1990s	Improved survival outcomes owing to earlier treatment	No
2000s onwards	Identification of active novel therapies	Sometimes
2010s onwards	Treatment tailoring	Poor effectiveness until now
Neoadjuvant endocrine therapy
1980s	Improved treatment of elderly patients (>70–75 years)a	Yes
1990s	Improved uptake of breast-conserving surgery	Yes
2000s onwards	Identification of active novel therapies	Sometimes
2010s onwards	Treatment tailoring	Poor effectiveness until now

^aOf note, no consensus exists on the cutoff to be used, and age should be considered together with other variables, such as performance status, comorbidities, social support, and cognition and psychological status.