Surgical considerations in locally advanced breast cancer patients receiving neoadjuvant chemotherapy.
OBJECTIVE
The definition of locally advanced breast cancer (LABC) includes patients with large tumors, extensive regional lymph node involvement, or direct involvement of the skin or underlying chest wall. Neoadjuvant chemotherapy followed by surgery has become the standard of care and a valuable strategy in the multimodality management of LABC. Variations in practice exist and the purpose of this article is to explore the surgical considerations in the management of LABC.


RESULTS
There exist various diagnostic and treatment considerations in LABC patients that help guiding clinicians in the optimal management of LABC. The evolving concepts of breast conservation, immediate breast reconstruction and optimal management of the axilla are addressed.


CONCLUSIONS
LABC represents a heterogenous cohort of patients for whom a multidisciplinary care team is critical. A more detailed understanding of the surgical considerations will facilitate the optimal diagnostic evaluation and management of these patients.
aOttawa Hospital Cancer Center and Ottawa Hospital Research Institute, Ottawa, Ontario bJewish General Hospital and Segal Cancer Center, Montreal, Quebec cLondon Regional Cancer Program, London Health Sciences Center, London, Ontario, Canada.
Angel
A
Arnaout
Jean-Francois
JF
Boileau
Muriel
M
Brackstone
D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D014943:Global Health; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D016462:Mammaplasty / Q000379:methods; D009367:Neoplasm Staging