title: Combined modality treatment for locally advanced breast cancer.
abstract: OBJECTIVE
  To assess the value of aggressive loco-regional surgery in desperate situations with locally advanced breast cancer.
  
  
  METHODS
  In this study there were considered 31 patients with locally advanced breast cancer who underwent surgery in a 5-year period. 10 of them received 3 cycles of chemotherapy and radiotherapy before surgical intervention; the rest of the 21 patients had systemic or local contra-indications for neo-adjuvant therapy. We describe clinical aspects and technical difficulties. Surgical intervention focused on tumour removal and lymph node dissection. Skin defect was covered with flaps according to the Mortimer-Show technique. Postoperatively, the outcome was influenced in a favourable way by the use of Detralex, a micronized flavonoid; all but 2 patients received chemotherapy and locoregional radiotherapy.
  
  
  RESULTS
  25 patients survived free of disease; from 6 patients who suffered recurrence, 2 are still living and 4 have died.
  
  
  CONCLUSIONS
  In some forms of locally advanced breast cancer, aggressive surgery offers improvement in the quality of life and increases survival.
authors.affiliation: 3rd Surgical Clinic, St. Spiridon Hospital, Gr. T. Popa University of Medicine & Pharmacy, Iasi, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Diaconu
authors.forename: V
authors.initials: V
authors.lastname: Gavrilovici
authors.forename: D
authors.initials: D
authors.lastname: Ghenghe
authors.forename: Cr
authors.initials: C
authors.lastname: Dragomir
authors.forename: Laurette
authors.initials: L
authors.lastname: Cozma
authors.forename: Ligia
authors.initials: L
authors.lastname: Ciornea
authors.forename: E
authors.initials: E
authors.lastname: Carasevici
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000628:therapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012494:Sampling Studies; D016019:Survival Analysis; D016896:Treatment Outcome