Locally advanced breast cancers are large cancers that are often fixed to the skin or the underlying chest wall muscles, and may be associated with large under arm lymph nodes. There is however, no associated skin redness (if there is redness we classify them as inflammatory breast cancers). These cancers have a better prognosis than do breast cancers with an associated inflammatory process.
The diagnosis of these tumors is straight-forward. We do a mammogram of both breasts and then do a core biopsy of the tumor. A metastatic workup is performed and a course of chemotherapy is given. In most cases this is followed by mastectomy and irradiation. The following link to two cases clinical cases which were successfully treated for locally advanced breast cancer. The following 2 examples are of patients recently treated at the breast care center, please note these pictures are graphic and viewer descretion is adviced.
See Example1: Treatment of advanced cancer with rectus abdominis flap. Elderly female presenting with large locally advanced breast cancer on the left. This patient was initially treated with chemo-therapy with approximately 80% reduction in tumor size. The breast was removed and the defect closed with a Tram flap. She responded remarkably well to the surgical procedure.
Example 2: Treatment of locally advanced cancer with vertical rectus abdominis flap. A young women presented with a locally advanced breast cancer and was treated with neo adjuvant chemo-therapy. She had only a partial response to therapy and had poorly controlled chest wall pain. A wide removal of the tumor was performed and a Tram flap reconstruction was used to close the mastectomy wound. She had excellent symptomatic relief for more than one year.