Surgical adjuvant treatment of locally advanced XXXX .

@entity1 @entity0 @entity39 @entity2080 @entity281
The reported incidence of local recurrence after mastectomy for locally advanced @entity0 (TNM Stage III and IV) is between 30% and 50%. The purpose of this study was to evaluate the effect of radiation therapy (XRT) followed by total mastectomy on the incidence of local recurrence in @entity1 with locally advanced @entity0 . Fifty-three @entity1 who presented with locally advanced @entity0 , without distant metastases, were treated with XRT (4500-5000 R) to the breast, chest wall, and regional lymph nodes. Five weeks after completion of XRT, total mastectomy was performed. There were no operative deaths. The complications that occurred in 22 @entity1 after surgery were flap @entity39 , wound @entity281 , and @entity2080 . @entity1 have been followed from 3 to 134 months. Twenty-five @entity1 are alive (3-134 months), 12 free of disease; 28 @entity1 have died with distant metastases (6-67 months). Isolated local recurrence occurred in only two @entity1 . Four @entity1 had local and distant recurrence (total local recurrence is 6/53). The remaining @entity1 all developed distant metastases. We have devised a treatment strategy which significantly decreases the incidence of local recurrence in @entity1 with locally advanced @entity0 . However, the rapid appearance of distant metastases emphasizes the need for systemically active therapy in @entity1 with locally advanced @entity0 .
