This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Endocrinology and breast, Subject name: Surgery
40 yr old female presented with breast lump of size 4 cm with involvement of skin and mobile palpable axillary LN, FNAC of lesion showed intrductal carcinoma. What is the initial management of for this pt? 
Select and explain. 
A. Radiotherapy, B. Neo-adjuvant chemotherapy, C. Modified radical mastectomy, D. Simple mastectomy
B: Neo-adjuvant chemotherapy
Answer: B: Neo-adjuvant chemotherapy 
Explanation: .Locally Advanced Carcinoma of Breast (LABC) * It means locally advanced tumour with muscle/chest wall involvement, extensive skin involvement or fixed axillary nodes. It will be T3, T4a, T4b, T4c or T4d or N2 or N3. * It is investigated by FNAC of tumor, mammography of opposite breast, chest CT, CT abdomen or whole body bone scan. Biopsy is needed to assess receptor status. * Treatment of LACB is always palliative by simple mastectomy, toilet mastectomy, chemotherapy and therapy using tamoxifen. * Initial neoadjuvant chemotherapy; surgery; radiotherapy; adjuvant chemotherapy are other therapeutic plan. ref:SRB&;s manual of surgery,ed 3,pg no 491