In this study, we evaluated the clinical presentation of patients with T4b breast cancer, and analyzed the impact of non- inflammatory skin involvement on long-term survival. We treated 1 228 cases of breast cancer patients during 2004 to 2010. The T4b breast cancers were 52 cases out of these 1,228 patients. The primary treatment methods of these T4b patients were chemotherapy (67.3%), surgical therapy (26.9%), endocrine therapy (5.8%), and radiation therapy (0%). The probability that surgical resection was performed over the duration of treatment was 88. 5%. The mean time to progression (TTP) was 3.9 years. The disease specific mean survival time (MST) of T4b breast cancer patients was 5.9 years. There was no difference among the surgical and non-surgical therapy groups in the long-term survival period, but the surgical therapy group was much better than non-surgical therapy group in terms of non-recurrent survival ratio. In viewing from the control of bleeding of the patients, the surgical therapy was effective and improved the quality of life during a time of the therapy.