Management of locally advanced breast cancer—perspectives and future directions

The definition of locally advanced breast cancer (LABC) can be broadened to include large operable tumours, however, we commonly use this term to refer to inoperable cancersThe management of LABC constitutes an important clinical problem, particularly in developing countries and those without widely adapted awareness programmesThe optimal management of LABC requires a multidisciplinary approach and collaboration between medical, surgical and radiation oncologistsFew data exist on LABC systemic treatment; the majority of data are from studies including both large-operable and locally advanced inoperable tumours—posing many challenges in the management of LABCSeveral new molecularly targeted agents are under clinical investigation aiming to improve the clinical outcome of patients with LABCThe negative results of the ALTTO trial after promising data from NeoALTTO advocate a reassessment of pathological complete response as a suitable surrogate marker for long-term outcome in breast cancer