Breast conservation therapy for patients with locally advanced breast cancer.

Neoadjuvant chemotherapy achieves high response rates in patients with breast cancer and has been used to reduce tumor size and allow for breast conservation in individuals who initially required mastectomy. The goals of this approach are to achieve optimal locoregional control together with acceptable cosmesis. In the setting of locally advanced disease, breast preservation appears to be feasible for appropriately selected patients whose tumors show adequate downstaging in response to induction chemotherapy. Nevertheless, further prospective randomized trials are warranted to better evaluate the results of this approach as compared with mastectomy.