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• W2000885291 abstract "Locally advanced breast cancer (LABC) accounts for 5% to 15% of new breast cancer cases in the United States and for 40% to 60% of new cases in nonindustrialized countries. The diagnosis of LABC includes tumors classified under TNM classification as stage IIB (T3N0), stage III (IIIA and IIIB), and regional stage IV breast cancer (ipsilateral supraclavicular lymph node [LN] metastases), according to the American Joint Committee for Cancer Staging.1 Based on the TNM system, LABC tumors must be larger than 5 cm (T3) and/or involve the skin or chest wall (T4) with any node (N), stage. Tumors of any tumor (T) category with N2 (matted axillary LN) or N3 (internal mammary LN) are also considered LABC. Inflammatory breast cancer (IBC) is a particularly aggressive form of LABC that has highly metastatic features, and it is classified as stage IIIB in the TNM system.42 Inflammatory breast cancer is a clinical-pathological entity characterized by the rapid development (usually within 3 months) of erythema and edema (also known as peau d'orange sign) and breast ridging (palpable striae in erythematous areas). In many cases no definite mass is found by physical examination or mammography. The typical mammographic finding is diffuse skin thickening. Microscopic examination of involved skin may show invasion of lymphatic vessels, although the typical pathologic findings are not needed to make the diagnosis of IBC. Patients with ipsilateral supraclavicular LN metastases (technically stage IV) and no evidence of distant metastases have a similar prognosis to patients with stage IIIB disease and are considered in the LABC category.9 During the first half of the twentieth century, patients with LABC underwent extensive surgical procedures and aggressive radiotherapy. The radical mastectomy was developed by William Halsted at the Johns Hopkins University for LABC patients. In the 1940s, Haagensen and others29 revisited the surgical indications for patients with LABC. These authors recognized that patients with extensive skin involvement or fixation to the chest wall (currently classified as T4 lesions) had a high rate of metastases and mortality when treated with surgery alone. For this reason (and not because of technical issues), patients with T4, N3, or regional M1 (stage IIIB/IV) were considered inoperable. Using surgery or radiation therapy (RT) as single-therapy modalities resulted in local control for most patients with LABC. However, more than 80% of patients died of metastatic disease within 5 years of follow-up. The prognosis was particularly poor for patients with IBC treated with local regional therapy only.36" @default.
• W2000885291 created "2016-06-24" @default.
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• W2000885291 date "1999-04-01" @default.
• W2000885291 modified "2023-10-06" @default.
• W2000885291 title "LOCALLY ADVANCED BREAST CANCER" @default.
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• W2000885291 doi "https://doi.org/10.1016/s0889-8588(05)70065-4" @default.
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