Abstract
Locally advanced breast cancer (LABC) and inflammatory breast cancer (IBC), a unique subtype of stage III breast cancer, are associated with a high risk of distant recurrence and worse survival. In recent years, refining of prognostic information based on estrogen receptor (ER)/progesterone receptor (PR)/human epidermal growth factor receptor-2 (HER2) biomarkers and the use of targeted therapies (antihormonal and anti-HER2 therapies) have changed the treatment paradigm and prognostics staging for LABC based on ER/PR/HER2 status according to the most recent AJCC 8th staging criteria. A multimodality therapy approach is recommended, with neoadjuvant systemic therapy preferred in general and always required for IBC. Therefore, multidisciplinary collaborative care is critical for the management of LABC. The increased use of neoadjuvant systemic therapy with effective targeted therapies, such as trastuzumab and pertuzumab, has impacted the treatment approach in recent years and improved survival. However, IBC remains a unique clinical entity, where the maximum trimodality approach is still recommended. Therefore, this chapter provides a separate section for IBC. Additional chapters (see Chapters 50 and 55) are dedicated to reviewing the local therapy approaches for LABC and IBC. Therefore this chapter will focus mainly on epidemiology, prognosis, and systemic therapy for LABC and noninflammatory LABC.
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