Locally advanced and inflammatory breast cancer.

Locally advanced breast cancer (LABC) and inflammatory breast cancer (IBC) were both initially commonly defined as breast cancers that were inoperable at presentation and/or as having an extremely poor survival with locoregional treatments alone. The first published descriptions of LABC by Haagensen and Stout in 1943 and of IBC by Bell in 1814 (eventually termed IBC by Lee and Tannebaum in 1924) have essentially held to form over time. Corresponding staging with the sixth edition of the American Joint Commission on Cancer criteria today would encompass the stage IIIA and B breast cancers. However, over time the cohort of LABCs has also tended to include primary tumors greater than 5 cm in size (T3N0 and T3N1). This article and its associated conclusions refer specifically to inoperable LABC and IBC at presentation (Table 1). The common thread regarding LABC/IBC is the consideration of neoadjuvant (also called primary) systemic therapy (NST) as the initial management of choice. The intent of NST in this setting is to improve surgical options (primarily operability) and to improve breast cancer survival.