Combined treatment modality was applied in 51 consecutive patients with locally advanced breast carcinoma between December 1982 and December 1984. The treatment was started with 4 cycles of chemotherapy with combination of adriamycin, vincristine, 5-fluorouracil and cyclophosphamide. This was followed by high-energy radiotherapy (45 Gy to the breast and lymphatic areas), with or without surgery. After radiotherapy, the response rate was 76%: 39/51 (complete response 39%: 20/51). Twenty-nine patients (57%) were treated conservatively (20 treated by radiotherapy alone and 9 treated by tumorectomy with axillary dissection followed by interstitial implantation). For 22 patients (43%), the mastectomy with axillary dissection was necessary. The three year overall survival rate and disease free survival rate were 88, and 86%. Local recurrences occurred in one patient (2%). The toxicity with this combined treatment regime was low. The cosmetic results were acceptable when a conservative treatment was proposed.