In inflammatory Ca breast with metastasis to axilla, treatment of choice is :

Ans. is None Inflammatory breast carcinoma is one of the most malignant form of breast cancer. It has been specifically assigned a special T code, Tod (which falls under stage IHb disease) It is an ominous clinical category of breast cancer associated with diffuse tumor involvement of the lymphatic channels within the breast and overlying skin. It is clinically manifested as erythema, edema (Peaud' orange) and warmth of the breast as a result of lymphatic obstruction. Often there is no distinct mass, since the tumor infiltrates the involved breast diffusely. Inflammatory cancer can occur with tumors of either ductal or lobular histology. The pathological hallmark on biopsy in presence of tumor cells within the dermal lymphatics. At the time of presentation, the disease has metastasized to axillary lymph nodes (in >75% cases) and distant sites (in -25% cases) Treatment - it was once a uniformly fatal disease with a median survival time of 9 to 12 months. - Currently, aggressive use of combined multimodality treatment has improved the outcome. it consists of : Neoadjuvant chemotherapy Surgery to remove residual cancer from chest wall & axilla (Mastectomy, modified radical mastectomy or radical mastectomy) Adjuvant chemotherapy Adjuvant radiation therapy Adjuvant hormonal therapy for receptor positive tumors