Medknow Publications on behalf of the Association of Radiation Oncologists of India (AROI)
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