NSABP B-18 — Preoperative Versus Postoperative Doxorubicin-Cyclophosphamide Chemotherapy for Operable Breast Cancer

Phase 3 · 1997 · Breast Cancer

Design

Randomized 4 cycles of doxorubicin-cyclophosphamide given preoperatively vs postoperatively.

Population

Operable (stage I-II) breast cancer.

Primary Endpoint

disease-free and overall survival

Key Result

Equivalent long-term survival regardless of timing; neoadjuvant chemotherapy increased breast-conservation rates, and pathologic complete response predicted better outcome.

Guideline Impact

Basis for neoadjuvant chemotherapy and pCR-guided care in breast cancer guidelines