Sequential Therapy in the Treatment of Locally Advanced Noninflammatory Breast Cancer

Optimal care of patients with locally advanced breast cancer requires the use and thoughtful integration of all effective modalities of treatment. A number of alternative combinations of surgery, chemotherapy, and radiation have been promoted, each with its own particular advantages and shortcomings. The advantages of sequenced, multimodality therapy of locally advanced, noninflammatory breast cancer include (1) the ability to convert nonresectable tumors to resectable ones, (2) early institution of systemic therapy, (3) in vivo evaluation of tumor response with the potential for optimization of therapy, and (4) relatively low morbidity rates with the ability to render most patients disease-free at their primary site. The results of this treatment strategy are discussed.