Surgical Management of Locally Advanced Breast Cancer

Because the greatest risk for patients with locally advanced breast cancer is the development of distant metastases and death, the goals of surgery are to obtain maximal locoregional control with minimal disfigurement and to enable accurate staging to determine prognosis and subsequent adjuvant therapy. Today, most cases of locally advanced breast cancer are large tumors that are technically resectable by standard mastectomy. If the advantages of induction chemotherapy are to allow selection of therapeutic strategies based on the tumor's in vivo chemosensitivity and to increase the frequency of breast preservation, then a combination of systemic and optimal local therapies may not only benefit the patient's quality of life but also have an impact on survival.