Locally advanced breast cancer in precision medicine era: a review of evolving diagnostic and therapeutic paradigms

doi:10.3877/cma.j.issn.1674-0807.2025.03.002

Abstract

Abstract:

Locally advanced breast cancer (LABC) is a subtype characterized by high heterogeneity and significant therapeutic challenges. There are some unresolved issues in its local and systemic treatment. Based on traditional staging criteria, precise assessment of surgical feasibility is fundamental to formulating refined treatment plans. For patients with operable LABC, radical surgery is recommended as the primary strategy, rather than routinely opting for neoadjuvant therapy. This approach mitigates risks of increased drug resistance or disease progression that may compromise surgical opportunities. In cases of initially inoperable LABC, neoadjuvant therapy aims to achieve tumor downstaging to enable surgery which remains central to LABC management. Even neoadjuvant therapy serves as a critical treatment modality, it is not an obligatory screening step. Recent advances in systemic therapeutics have expanded options for adjuvant and intensive treatment, and sparked debates regarding optimal timing of interventions. This article synthesizes clinical research progress in LABC to explore current controversies in its diagnosis and therapeutic decision-making.

Key words: Breast neoplasms, Surgical procedures, operative, Precision medicine, Intensive therapy

Ying Xu, Yu Song, Xin Huang, Yidong Zhou, Qiang Sun, Yan Lin. Locally advanced breast cancer in precision medicine era: a review of evolving diagnostic and therapeutic paradigms[J]. Chinese Journal of Breast Disease(Electronic Edition), 2025, 19(03): 139-144.

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