Ultrasound Clinics Breast Cancer

Table of contents :
Cover……Page 1
Foreword……Page 2
Preface……Page 5
National Surgical Adjuvant Breast Project B-04……Page 7
National Surgical Adjuvant Breast Project B-06……Page 9
National Surgical Adjuvant Breast Project B-21……Page 10
National Surgical Adjuvant Breast Project B-32……Page 11
National Surgical Adjuvant Breast Project B-39……Page 12
National Surgical Adjuvant Breast Project protocols for the management of ductal carcinoma in situ……Page 13
National Surgical Adjuvant Breast Project B-17……Page 14
National Surgical Adjuvant Breast Project B-24……Page 15
National Surgical Adjuvant Breast Project B-35……Page 16
Studies in patients who have estrogen-receptor negative tumors: National Surgical Adjuvant Breast Project B-13, B-19, and B-23……Page 17
Studies in patients who have estrogen-receptor positive tumors: National Surgical Adjuvant Breast Project B-14 and B-20……Page 19
National Surgical Adjuvant Breast Project B-33……Page 21
National Surgical Adjuvant Breast Project B-42……Page 22
National Surgical Adjuvant Breast Project B-30……Page 23
National Surgical Adjuvant Breast Project B-31……Page 24
National Surgical Adjuvant Breast Project B-18……Page 25
National Surgical Adjuvant Breast Project B-27……Page 27
Summary……Page 28
References……Page 29
Breast cancer risk assessment……Page 34
Medical risk reduction with chemoprevention……Page 35
Surgical risk reduction with prophylactic oophorectomy or prophylactic mastectomy……Page 39
Summary……Page 40
References……Page 41
Cancer risk assessment and patient selection……Page 44
Efficacy of prophylactic mastectomy……Page 46
Impact of bilateral prophylactic mastectomy on breast cancer incidence……Page 47
Surgical morbidity of bilateral prophylactic mastectomy……Page 48
Impact of contralateral prophylactic mastectomy on breast cancer incidence……Page 49
Impact of contralateral prophylactic mastectomy on survival……Page 50
Surgical morbidity and quality of life of contralateral prophylactic mastectomy……Page 51
Risk reduction alternatives to prophylactic mastectomy……Page 52
Future directions……Page 53
References……Page 54
Ductal Carcinoma In Situ-Current Management……Page 59
Classification……Page 60
Investigation and diagnosis……Page 61
Breast-conserving surgery……Page 62
The benefit of radiation treatment……Page 64
Axillary surgery/sentinel lymph node biopsy……Page 66
Use of endocrine therapy in ductal carcinoma in situ……Page 67
Selection of treatment for the individual patient……Page 69
Summary……Page 71
References……Page 72
Lymphatic Mapping Techniques and Sentinel Lymph Node Biopsy in Breast Cancer……Page 78
Blue dye……Page 79
Filtered versus unfiltered radioisotope……Page 81
Subareolar and dermal injection……Page 82
Preoperative lymphoscintigraphy……Page 84
Timing of radioisotope injection……Page 85
The future and controversies……Page 86
References……Page 87
Axillary Management After Sentinel Lymph Node Biopsy in Breast Cancer Patients……Page 90
Nonsentinel node metastases……Page 91
Survival impact……Page 92
Local recurrence……Page 93
American College of Surgeons Oncology Group Z0010 trial……Page 95
American College of Surgeons Oncology Group Z0011 trial……Page 96
Axillary Lymphatic Mapping Against Nodal Axillary Clearance trial……Page 97
Predicting the status of nonsentinel nodes……Page 98
Is there still a role for axillary lymph node dissection?……Page 99
References……Page 100
Management of Patients with Locally Advanced Breast Cancer……Page 103
Evolution of treatment options in locally advanced breast cancer……Page 104
Diagnostic and therapeutic management sequence……Page 105
Breast conservation therapy versus mastectomy……Page 108
Optimal preoperative systemic therapy regimen……Page 109
Locoregional irradiation for locally advanced breast cancer patients treated with neoadjuvant chemotherapy……Page 111
Integration of lymphatic mapping/sentinel lymph node biopsy into neoadjuvant chemotherapy protocols……Page 112
Summary……Page 117
References……Page 118
Neoadjuvant Systemic Therapy and the Surgical Management of Breast Cancer……Page 123
Indications for neoadjuvant chemotherapy……Page 124
Neoadjuvant chemotherapy regimens……Page 125
Tumor response and survival……Page 126
Neoadjuvant chemotherapy and use of breast-conserving surgery……Page 129
Diagnosis and management of axillary node metastases……Page 130
References……Page 135
Epidemiology……Page 140
Pathology……Page 141
Diagnostic evaluation……Page 143
Irradiation……Page 146
Management of the axilla……Page 147
Systemic therapy……Page 148
References……Page 150
General wound complications related to breast and axillary surgery……Page 154
Wound infections……Page 155
Seroma……Page 159
Chronic pain……Page 161
Incisional dog-ears……Page 162
Breast fibrosis, breast lymphedema, and chronic/recurrent breast cellulitis……Page 163
Complications related to lumpectomy and brachytherapy……Page 164
Sampling error……Page 165
Complications associated with auxiliary lymph node dissection……Page 167
Complications associated with lymphatic mapping and sentinel lymph node biopsy……Page 169
References……Page 170
Historical background……Page 175
Preoperative counseling……Page 176
Immediate reconstruction……Page 177
Indications/contraindications……Page 178
Technique……Page 179
Indications/contraindications……Page 180
Technique……Page 181
Microsurgical transverse rectus myocutaneous flap……Page 182
Deep inferior epigastric perforator……Page 183
Gluteal artery perforator flap……Page 184
Advantages/disadvantages……Page 185
Nipple and areolar reconstruction……Page 186
References……Page 187
Use of Ultrasound in Breast Surgery……Page 190
Characteristics of ultrasound lesions……Page 191
Nipple discharge……Page 192
Mammographic abnormalities……Page 193
Screening……Page 194
General technique for percutaneous biopsy……Page 195
Ultrasound core needle biopsy……Page 196
Ultrasound vacuum-assisted excisional breast biopsy……Page 197
Radiofrequency cutting devices……Page 198
Ultrasound central line/port insertions……Page 199
Ultrasound-guided excision of nonpalpable masses……Page 200
Ultrasound localization of nonpalpable lesions by iatrogenically induced hematomas……Page 201
Ablative ultrasound-guided procedures……Page 202
Summary……Page 203
References……Page 204
Integrating Partial Breast Irradiation into Surgical Practice and Clinical Trials……Page 206
Theoretical advantages of accelerated partial breast irradiation……Page 207
Interstitial catheter-based brachytherapy……Page 208
Balloon-based intracavitary brachytherapy……Page 211
Three-dimensional conformal radiation therapy……Page 213
Single-fraction intraoperative radiation therapy……Page 215
Ongoing phase III trials of whole-breast irradiation versus accelerated partial breast irradiation and future directions……Page 216
References……Page 217
Overview of Adjuvant Systemic Therapy in Early Stage Breast Cancer……Page 220
Algorithms for adjuvant systemic therapy decisions……Page 221
Selection of patients who can avoid systemic therapy completely……Page 223
Systemic therapy for endocrine-responsive breast cancer……Page 224
Endocrine therapy for postmenopausal cases……Page 225
Selection and dosing of chemotherapy regimen……Page 226
Targeted therapy for breast cancer with trastuzamab (herceptin)……Page 227
References……Page 228
Postmastectomy Radiation Therapy: Indications and Controversies……Page 231
Current practice: the 2001 American Society of Clinical Oncology guidelines……Page 234
Current practice: controversy regarding postmastectomy radiation therapy for patients who have one to three metastatic axillary nodes……Page 235
Current practice: controversy regarding postmastectomy radiation therapy for patients who have T3, node-negative breast cancer……Page 239
Current practice: controversy regarding postmastectomy radiation therapy for patients treated with neoadjuvant chemotherapy……Page 240
Current practice: controversy regarding postmastectomy radiation therapy for margin control……Page 242
Summary……Page 243
References……Page 244
Background……Page 247
New molecular-based hypotheses of metastasis in breast cancer……Page 249
Tumor dormancy theory……Page 251
Stage IV presentations and breast cancer survival……Page 252
Resection of the intact primary in Stage IV breast cancer……Page 253
Summary……Page 256
References……Page 257
Percutaneous ablation……Page 259
Lack of real-time imaging……Page 262
Imaging expertise required……Page 263
Pathological assessment of ablation zone……Page 264
Fibroadenomas……Page 265
Breast cancer……Page 267
Breast cancer……Page 268
References……Page 269
Breast cancer in African American women……Page 271
Breast cancer in African women……Page 274
Comparisons of breast cancer in women of African ancestry……Page 276
Estrogen receptor, genetic association studies, and breast cancer risk……Page 277
Summary……Page 279
References……Page 285