This protocol applies to patients with solid papillary carcinoma of the breast with evidence of invasion presenting as inflammatory breast cancer or locally advanced breast cancer, where the preceding systemic treatment did not achieve the required tumour response.
The patient has inflammatory breast cancer or locally advanced breast cancer — presentations that require a sequenced, multi-modality approach. Initial systemic therapy is used to downstage disease before any definitive local intervention is considered.
The preceding step was neo-adjuvant chemotherapy. The defined goal — a meaningful reduction in breast tumour size, assessed at 3–4 cycles — was not achieved. This failure to reach the target tumour response is the trigger for escalation to the current protocol.
The majority of inflammatory cancers will be treated with neo-adjuvant chemotherapy, definitive mastectomy followed by postoperative radiotherapy.