LOCALLY ADVANCED NONINFLAMMATORY BREAST-CANCER

Locally advanced noninflammatory breast cancer represents 10% to 15% o f all patients at diagnosis. The greatest risk for these patients is t he development of distant metastases that lead to death. Local therapi es, including surgery and radiation therapy, used in combination resul t in improved locoregional control but have no significant effect on s urvival. The institution of mulitmodality treatment regimens that incl ude systemic chemotherapy has improved distant disease-free survival. The appropriate sequencing of local and systemic treatment still is de bated. Advantages to preoperative chemotherapy are assessment of in vi vo chemosensitivity and the option for breast-conserving surgery in pa tients with tumor down staging.