If a cancer is large when it is first treated it may be categorized as locally advanced according to the criteria described by Dr. Guth a surgeon and Dr. Novik an Oncologist. Initial treatment is usually a combination of chemo-hormonal therapy ‘up front ‘ – that is, before there is any surgery. The response to treatment predicts prognosis. Sometimes tumor shrinkage is so dramatic that a lumpectomy can be performed. Breast reconstruction may be feasible following a mastectomy. This multidisciplinary treatment has accomplished the best results. -- Peter Pressman, MDmoreless
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