A patient presents with a unilateral ca breast of 4 cm size with skin ulceration involving the nipple. On palpation axillary lymph nodes are positive. Management would involve:

Here this patient is having Stage III disease (T4, N1 or N2, M0) according to the TNM table given above. Hence the management would be - Neoadjuvant chemotherapy + MRM + adjuvant radiation therapy + chemotherapy + antiestrogen therapy