ASBTRACT
The Role of Bone Marrow Transplantation
in the Management of Advanced Local Disease
from the series "Management Strategies for the Care of Advanced Primary and Metastatic Breast Cancer"
Hana Safah, M.D. and
Roy S. Weiner, M.D.
LOCALLY ADVANCED BREAST CANCER
The term locally advanced breast cancer (LABC) comprises a heterogenous group of breast cancers that includes large primary (T3, T4) tumors, tumors with fixed ipsilateral axillar (N2), tumors with ipsilateral supraclavicular or infraclavicular nodes, or tumors producing arm edema (N3). This group includes patients whose tumors are clearly resectable, as well as patients in Haagensen's inoperable classification based on poor prognosis after radical resection when surgery was the only available treatment modality. Patients with ipsilateral supraclavicular node involvement (M1, stage IV) are smetimes included, because all of their disease can be encompassed by a locoregional radiotherapy field. Inflammatory breast cancer (IBC) is a subset of what was considered technically inoperable locally advanced breast cancer that has been variously defined on the basis of both clinical and pathologic criteria. The clinical definition is the presence of color, erythema, and peau d'orange in the involved breast. The pathologic criterion is the presence of tumor emboli in dermal lymphatics and small vessels of the breast. Inflammatory carcinoma (T4d) has been characterized by a high rate of locoregional recurrence after mastectomy, the rapid development of multiorgan metastases, and historically almost uniform mortality within the first 2 years.
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This page was posted in June 1997.