TransMed: Stage IIIB- Therapeutic Options

BREAST CARCINOMA STAGE III B (Locally Advanced)
TMN Classification	T4NO-3M0 T1-4N3M0 Includes Inflammatory Carcinoma
Cell Type	All
Description	Any Tumor Size with chest wall involvement with or without Lymph Node Metastasis or Any Tumor Size with cancerous Lymph nodes beneath the sternum

Surgical Therapeutic Option 1: FNA or Incisional Biopsy (Systemic Chemo and Hormonal Rx) with Palliative Local External Beam Radiation
Indication	Biopsy needed for ER-PR Status / External beam radiation for local palliation.

Surgical Therapeutic Option 2: FNA or Incisional Biopsy (Systemic Chemo and Hormonal Rx) with delayed Mastectomy or Lumpectomy with Axillary Dissection
Indication	Biopsy needed for ER-PR Status / Mastectomy for local control (so-called toilet mastectomy)

RECOMMENDATION FOR STAGE IIIB LYMPH NODES POSITIVE OR NEGATIVE- ER/PR POSITIVE OR NEGATIVE
TMN Classification	T4N0-3M0 or T1-4N3M0
Description	Any Tumor Size with chest wall involvement with or without Lymph Node Metastasis or Any Tumor Size with cancerous Lymph nodes beneath the sternum
Recommendation	CHEMOTHERAPY RECOMMENDED - HORMONAL THERAPY RECOMMENDED FOR ER/PR POSITIVE PATIENTS
RECOMMENDED CHEMOTHERAPEUTIC PROTOCOLS
CLICK ON EACH PROTOCOL FOR DETAILED INFORMATION	ADRIAMYCIN CYTOXAN & TAMOXIFEN aka: AC-T	CYTOXAN METHOTREXATE 5FU & TAMOXIFEN aka: CMF-T	ORAL CYTOXAN METHOTREXATE 5FU & TAMOXIFEN aka: Classic CMF-T	5FU ADRIAMYCIN CYTOXAN & TAMOXIFEN aka: FAC-T
*All patients with large tumors should be considered for neoadjuvant treatment.* *Patients with inflammatory carcinoma should be considered for autologous transplant when initial therapy is completed.* *Patients with inflammatory carcinoma should be considered for neoadjuvant chemotherapy.*