Inflammed breast (peau d'orange): Surgery

My sister, now 40 yrs old had a recurrence after a year since first diagnosed 2 years ago, of having an invasive ductal carcinoma on the left breast, had 8 cycles of chemotherapy and 35x radiation treatments. But this time the right breast is inflammed and is inoperable for now.  She is to finish 10 cycles of chemo( vinorelbine & oxaliplatin). SO far she is on the 5th cycle this coming week. Is this the usual no. of cycles required for inflammed breast before surgery can be done? What are the factors surgeons/oncologists consider to determine whether or not they can proceed to surgery?


Micky

[CCF-RN,MSN-rf]

Dear Micky:  The cancer in her right breast would be considered a new primary breast cancer and would be treated as such.  The choice to use chemotherapy first is standard - the drug choices may differ and the number of cycles depends on the drugs. As oxaliplatin is not approved in the U.S., I am assuming your sister does not live in the U.S. and the protocols here may differ.  Inflammatory breast cancer is considered systemic at diagnosis so surgery is done after chemotherapy has effectively eradicated the evidence of the disease.  The mastectomy would be followed by more chemotherapy and radiation therapy.

[healedbyJesus]

If the chemotherapy eradicates the evidence of the disease, why is surgery necessary and why would the patient need more chemotherapy and/or radiation?