There are several indications of a locally advanced breast cancer: a stage 3 cancer, with a size larger than two inches and metastasis in lymph nodes, skin inflammation, or a large group of lymph nodes involved in armpit, or you might hit the chest muscle, or skin ulcers.All these are indications that breast cancer is likely to have spread to other parts of the body, at least under the microscope and thus, when discovered, surgery is not always the first step. lymph node sampling is not necessary. There is often a question of whether wide excision is still possible. If you have very large breasts may be, but if your breasts are small, surgeons may not be able to get enough surrounding tissue out without a mastectomy. The tumor is stuck in the chest muscle or ulcer in the breast skin, immediate local treatment would not be possible at all, remove the entire muscle or skin that is sore I could not leave enough fabric to sew together again .