Combined modality treatment for locally advanced breast cancer

Purpose: To assess the value of aggressive loco-regional surgery in desperate situations with locally advanced breast cancer. Methods: In this study there were considered 31 patients with locally advanced breast cancer who underwent surgery in a 5-year period. 10 of them received 3 cycles of chemotherapy and radiotherapy before surgical intervention; the rest of the 21 patients had systemic or local contra-indications for neo-adjuvant therapy. We describe clinical aspects and technical difficulties. Surgical intervention focused on tumour removal and lymph node dissection. Skin defect was covered with flaps according to the Mortimer-Show technique. Postoperatively, the outcome was influenced in a favourable way by the use of Detralex, a micronised flavonoid; all but 2 patients received chemotherapy and locoregional radiotherapy. Results: 25 patients survived free of disease; from 6 patients who suffered recurrence, 2 are still living and 4 have died. Conclusions: In some forms of locally advanced breast cancer, aggressive surgery offers improvement in the quality of life and increases survival.