title: Management of locally advanced breast cancer: evolution and current practice.
abstract: Locally advanced breast cancer (LABC) accounts for a sizeable number (30-60%) of breast cancer cases and is a common clinical scenario in developing countries. The treatment of LABC has evolved from single modality treatment, consisting of radical mutilating surgery or higher doses of radiotherapy in inoperable disease to multimodality management, which along with the above two included systemic therapy. Neoadjuvant chemotherapy (NACT) has made a tremendous impact on the management of LABC. NACT was initiated to institute systemic therapy upfront at the earliest in this group of patients with a high risk of micrometastasis burden. While NACT did not yield a survival advantage, it has however made breast conservation possible in selected group of cases. Large number of studies and many randomised trials have been done in women with LABC in order to improve the therapeutic decisions and also the local control and survival. With this background we have reviewed various treatment options in patients with LABC which should possibly help in guiding the clinicians for optimal management of LABC.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Rustogi
authors.forename: Ashwini
authors.initials: A
authors.lastname: Budrukkar
authors.forename: Ketayun
authors.initials: K
authors.lastname: Dinshaw
authors.forename: Rakesh
authors.initials: R
authors.lastname: Jalali
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents