title: Surgical approach for ulcerated locally advanced breast cancer. A single Center experience: a retrospective study.
abstract: OBJECTIVE
  The aim of our retrospective study is to analyze surgical possibilities for the extended LABC in those cases not suitable for a neoadjuvant chemotherapy step and to consider various reconstruction techniques.
  
  
  METHODS
  Between 2009 and 2015 we enrolled 11 patients, admitted to the Emergency Department, presenting ulcerated LABC that needed palliative surgical demolitive procedures because of bleeding and anemia and in which was necessary to use natural tissues transposition or synthetic substitutes for the reconstruction of the skin flaps.
  
  
  RESULTS
  The mean follow up was 12 months. Mortality rate was 82% (9 patients); in 2 cases there was local relapse after 6 months; 9 months was the longest disease free survival.
  
  
  CONCLUSIONS
  Thanks to multidisciplinary strategies LABC's surgical treatment improved results with a five-year survival rate between 30-40% and better quality of survival. Despite extended demolitive approach, there is still a 50% of death because of metastases.
  
  
  CONCLUSIONS
  Our results confirm that musculocutaneous flap, skin anterior thigh grafts, bilayer matrix wound dressing are excellent reconstructive strategies in locally advanced ulcerated breast cancer after aggressive extended surgery even if palliative to improve patients' further survival. Our data also showed that those patients presenting medium level of malignancy as "luminal b" subtype (7 patients) if treated earlier with a radical surgical procedure would have better prognosis.
  
  
  BACKGROUND
  Oncoplastic techniques, Ulcerated breast cancer.
authors.forename: Rita
authors.initials: R
authors.lastname: Laforgia
authors.forename: Clelia
authors.initials: C
authors.lastname: Punzo
authors.forename: Annunziata
authors.initials: A
authors.lastname: Panebianco
authors.forename: Annalisa
authors.initials: A
authors.lastname: Volpi
authors.forename: Marina
authors.initials: M
authors.lastname: Minafra
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sederino
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000473:pathology; D013524:Surgical Flaps; D016896:Treatment Outcome