Neoadjuvant Therapy

See the current version of the SEER Program Coding Manual under Reporting Guidelines, Section VII: First course of therapy, for complete coding instructions for the neoadjuvant data items. See also Appendix C.

For breast cancers, neoadjuvant therapy is used for several stages of disease and can include chemotherapy alone, chemotherapy with immunotherapy, chemotherapy with radiation therapy (concurrent) or hormone therapy.

Neoadjuvant therapy is used to shrink the tumor so that it may be more amenable to a breast conserving surgical resection (excisional biopsy or lumpectomy).

If neoadjuvant therapy followed by surgery, do not record the size from the pathologic specimen. Code the largest size of tumor prior to neoadjuvant treatment; if unknown code size as 999

Neoadjuvant therapy is systemic therapy that is administered prior to surgical resection. This may include chemotherapy, hormone, immunotherapy and/or radiation. For a treatment to be noted as neoadjuvant therapy, it must meet the treatment guidelines. (See the NCCN Breast Cancer Guidelines, to determine the appropriate guidelines for neoadjuvant therapy.)

If only systemic therapy (chemo, hormone, immune) or radiation are given (no surgical resection), then this is adjuvant therapy.

Document neoadjuvant therapy details in NAACCR Item #’s (as applicable)

• 2620: Text-Dx Proc-Radiation (Beam)
• 2630: Text-Dx Proc-Radiation Other
• 2640: Text-Chemo
• 2650: Text-Hormones
• 2660: Text-BRM
• 2670: Text-Other

See Additional resources for Breast cancer treatment for more information.

Updated: January 10, 2025