Factors Responsible for Discordant Response to Neoadjuvant Systemic Therapy in T4b Breast Cancer

Neoadjuvant systemic therapy is the standard of care in the treatment of locally advanced breast cancer. Heterogeneity of tumour microenvironment complicates the response to the treatment. Very few studies focus on the response pattern of neoadjuvant chemotherapy in locally advanced breast carcinoma. We aim to hypothesize that breast cancer microenvironment has a heterogeneous pattern. This is prominent when skin is involved and can be attributed to a higher distribution of cancer stem cells on the surface compared to the core and is independent of tumour biology.