The appropriate management of locally advanced breast carcinoma (LABC) is controversial. It is evident that overall survival in patients treated with locoregional control remains dismal. The trend towards a more effective means of improving response rates and overall survival in LABC has shifted towards earlier aggressive treatment to include neoadjuvant chemotherapy. A known histopathological diagnosis is required prior to the implementation of therapy, which is dependent upon the initial method used to obtain tissue. We advocate the use of large core (14 g) needle breast biopsy over other commonly employed techniques. This technique is reliable, safe, and efficient.