Pattern of Care in Locally Advanced Breast Cancer: Focus on Local Therapy

Background And Methods: The optimal treatment of locally advanced breast cancer (LABC) remains undetermined. We analyzed factors influencing local therapy in LABC in a pooled material including three large clinical series.

Results: Of a total of 787 patients, local therapy was given in 604, surgery in 184, radiotherapy in 69, and a combination thereof in 351. The use of local therapy was related to younger age, lower clinical T and N stage, no skin involvement and no progression during induction chemotherapy. The use of surgery was related to younger age, lower clinical T and N stage, no clinical skin involvement and response to induction chemotherapy. The use of postoperative radiotherapy was correlated with larger tumor size, higher number of positive lymph nodes, positive surgical margin, extracapsular lymph node extension, lymphatic vessel invasion and skin involvement.

Conclusions: The most frequent local therapy in LABC remains a combination of surgery and radiotherapy. Clinical and pathological characteristics influence the type of local treatment.