<qa>  What is the standard of care for locally advanced breast cancer?Neoadjuvant chemotherapy: Preoperative chemotherapy for large tumors 3cm or inoperable breast cancer is well established and is the standard of care for locally advanced breast cancer. Data from large series of patients have demonstrated that preoperative neoadjuvant chemotherapy leads to significant reduction of tumor size downstaging and improves both the rate and the cosmetic results of breast-conserving surgery. A recent large randomized trial involving 1,523 patients compared preoperative and postoperative chemotherapy NSABP B-18. Although results of this study have shown no difference in disease-free survival and survival in women on preoperative or postoperative doxorubicin and cyclophosphamide chemotherapy, significant downstaging of tumors was achieved so that more patients who received preoperative therapy were able to undergo breast-conserving surgery. The rate of breast conservation in NSABP B-18 was 85 in patients with tumors greater than 3 cm, with less than 5 of patients reported to have progressive disease while receiving neoadjuvant chemotherapy. 