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What is locally advanced breast cancer?

There is no single definition for locally advanced breast cancer. There are, however, some common elements which are identified during diagnosis. If your doctor has told you that you have locally advanced breast cancer, it’s likely that your breast cancer has some (or all) of the following features:

  • a tumour that may be larger than five centimetres;
  • cancer cells that may have spread to other tissues around the breast, such as the skin, muscle or ribs;
  • cancer cells that may have spread extensively to the lymph nodes.

It’s important to understand that locally advanced breast cancer is not the same as metastatic breast cancer. Metastatic breast cancer occurs where breast cancer has spread to other, more distant parts of the body. Read more about metastatic breast cancer here

Treatment for locally advanced breast cancer

Every breast cancer is different. Depending on your individual circumstances, your doctor may recommend one or more of the following treatments: surgery (mastectomy or lumpectomy), radiotherapy, or chemotherapy. Depending on your type of breast cancer, you may also be offered hormone therapy or Herceptin.

Treatments for locally advanced breast cancer are similar to the treatments for other types of breast cancers. Depending on the size of your breast cancer or the way in which it has spread, your treatments may be offered at different stages from other people.

If you have questions or concerns about any part of your treatment, it’s a good idea to ask one of your doctors. Don’t be afraid to ask your doctors to explain why a particular approach has been recommended.

Surgery

Not everyone with locally advanced breast cancer has surgery. Of those who do, mastectomy is most common. In some cases breast conserving surgery may be performed as an alternative. 

Do you want to read more about the types of breast cancer surgery? Visit the surgery page of our website.

Radiotherapy

Radiotherapy is often recommended as a treatment for people with locally advanced breast cancer. Depending on your individual treatment plan, radiotherapy may be offered before, after, or without surgery. If you have any concerns or questions about the timing of your treatment, it’s a good idea to talk to your doctor.

You can read more about radiotherapy here.

Chemotherapy

If you have locally advanced breast cancer, you will probably be offered chemotherapy. Again, the timing of your chemotherapy will depend on your own individual circumstances.

It is common for people with locally advanced breast cancer to have chemotherapy before surgery. This is called neoadjuvant chemotherapy.

Further information about chemotherapy drugs and side effects can be found here.

Neoadjuvant Chemotherapy

People with locally advanced breast cancer are usually offered chemotherapy early in their breast cancer treatment. When it is used before surgery, it is called neoadjuvant chemotherapy.

Neoadjuvant chemotherapy is usually given to shrink the breast cancer and to destroy any undetectable cancer cells that may be elsewhere in the body. It is sometimes referred to as preoperative chemotherapy, induction chemotherapy or primary system therapy.

If you hear other people talking about having their chemotherapy after their surgery, do not be alarmed. It’s likely that they have a different type of breast cancer and a different treatment plan. Neoadjuvant chemotherapy is not recommended for everyone.

Neoadjuvant Herceptin

People with locally advanced HER2-positive breast cancer may be offered Herceptin before their surgery. Information about HER2-positive breast cancer and Herceptin can be found in the My Journey Kit.

Hormone therapy

Is your breast cancer hormone receptor positive (ER+ and/or PR+)? If so, you may be offered a long-term hormone therapy. These are a tablet taken every day for 5 years or more. The most common types of hormone therapy medications are:

  • Tamoxifen
  • Aromatase inhibitors, including Arimidex (anastrozole), Femara (letrozole) and Aromasin (exemestane)

BCNA’s Hormone therapy and breast cancer booklet explains how hormone therapies work and discusses ways to help manage the side effects that some people experience with them.

Inflammatory breast cancer

Inflammatory breast cancer is sometimes referred to as a ‘type’ of locally advanced breast cancer.

More information

If you would like more information about locally advanced breast cancer and treatment options, take a look at:

  • Cancer Australia’s Guide for women with early breast cancer. This is provided free of charge in BCNA’s My Journey Kit. If you have not received a My Journey Kit, you can order it online, or call 1800 500 258.
  • The Cancer Australia website.