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1、REVIEWSManagementoflocallyadvancedbreastcancer—perspectivesandfuturedirectionsKonstantinosTryfonidis,ElzbietaSenkus,MariaJ.CardosoandFatimaCardosoAbstract
2、Locallyadvancedbreastcancer(LABC)constitutesaheterogeneousentitythatincludesadvanced‑stageprimaryt
3、umours,cancerswithextensivenodalinvolvementandinflammatorybreastcarcinomas.AlthoughthedefinitionofLABCcanbebroadenedtoincludesomelargeoperablebreasttumours,weusethistermtostrictlyrefertoinoperablecancersthatareincludedintheabove‑mentionedcategories.Thep
4、rognosisofsuchtumoursisoftenunfavourable;despiteaggressivetreatment,manypatientseventuallydevelopdistantmetastasesanddiefromthedisease.Advancesinsystemictherapy,includingradiationtreatment,surgicaltechniquesandthedevelopmentofnewtargetedagentshavesignif
5、icantlyimprovedclinicaloutcomesforpatientswiththisdisease.Notwithstandingtheseadvances,LABCremainsanimportantclinicalproblem,particularlyindevelopingcountriesandthosewithoutwidelyadaptedbreastcancerawarenessprogrammes.TheoptimalmanagementofLABCrequiresa
6、multidisciplinaryapproach,awell‑coordinatedtreatmentscheduleandclosecooperationbetweenmedical,surgicalandradiationoncologists.InthisReview,we discussthecurrentstateoftheartandpossiblefuturetreatmentstrategiesforpatientswithLABC.Tryfonidis,K.et al.Nat.Re
7、v.Clin.Oncol.12,147–162(2015);publishedonline10February2015;doi:10.1038/nrclinonc.2015.13IntroductionLocallyadvancedinoperablebreastcancer(LABC)con-breastarea.Clinicaldiagnosisisusuallyaccompaniedstitutesamajorclinicalchallenge,becausethevastmajor-bypat
8、hologicalfindingsoftumouremboliindermalityofpatientswithLABCwillexperiencediseaserelapselymphatics,althoughthisfindingisnotnecessaryorandeventuallydie,despiteaggressivemultimodalitysufficient(ifclinicalsymptomsarelacking)toconfirmtreatment.1LABCusuallye
9、ncompassesstageIIIdisease,thediagnosisofIBC.4,5Theterm‘secondaryinflamma-definedasT0–T3primarytumourswithclinicallydetect-torybreastcarcinoma’isusedtodescribeskinchangesableaxillary(mattedorfixed),ipsilateralinfraclavicular,mimic
