How would you manage a patient with a rapidly growing, clinically localized breast cancer who is medically inoperable?  

I would consider chemoRT for a medically inoperable breast cancer. Here is a prospective trial (https://www.ncbi.nlm.nih.gov/pubmed/20878462) that used paclitaxel and radiation to treat locally advanced breast cancer in the pre-op setting. I use this in the palliative setting for medically inoperabl...