The Breast Comprehensive Management of Benign and Malignant Diseases 5th Edition PDF

Instructions for online access
Cover image
Title Page
Michelangelo
Copyright
Dedication
Contributors
Preface
Acknowledgments
Video Contents
5
Section I History of the Therapy of Breast Cancer
1 History of the Therapy of Breast Cancer
Ancient Civilizations
Middle Ages
Renaissance
Eighteenth Century
Nineteenth Century
Twentieth Century
References
Section II Anatomy and Physiology of the Normal
and Lactating Breast
2 Anatomy of the Breast, Axilla, Chest Wall, and Related Metastatic
Sites
Gross Anatomic Structure: Surface Anatomy
Microscopic Anatomic Structure
Lymphatic Drainage of the Breast
References
3 Breast Physiology
Embryology to Childhood
Puberty
Pregnancy
6
Lactation
Regulatory Factors and Potential Genes
Menopause
Acknowledgment
References
4 Discharges and Secretions of the Nipple
Introduction and Definitions
Clinical Evaluation and Management of the Patient With Nipple
Discharge
Diagnosis and Surgical Intervention
Summary
References
Section III Benign and Premalignant Lesions
5 Etiology and Management of Benign Breast Disease
Breast Pain
Benign Breast Disorders
References
6 Mastitis and Breast Abscess
Mastitis
Lactational Mastitis and Abscess
Periductal Abscess/Chronic Subareolar Abscess
7
Idiopathic Granulomatous Mastitis
References
7 Gynecomastia
Prevalence
Clinical Presentation
Physiology
Histopathology
Pathophysiology
Management of Gynecomastia
Summary
References
8 Benign, High-Risk, and Premalignant Lesions of the Breast
Benign Lesions Without Cancer Risk Implications
Epithelial Hyperplasia and Proliferative Breast Disease
Atypical Hyperplasia
Localized Sclerosing Lesions
Duct Ectasia and Fat Necrosis
Fibroadenoma and Phyllodes Tumor
References
Section IV Pathology of Malignant Lesions
9 In Situ Carcinomas of the Breast
8
Recent Insights Into the Unique Biology of Ductal Carcinoma in Situ
and Lobular Carcinoma in Situ
Pathology of Ductal Carcinoma in Situ
Classification of Ductal Carcinoma in Situ
Extent of Disease
Extensiveness, Multicentricity, and Multifocality
Distribution
Mammographic Correlation
Margin Status
Risks of Evolution and Recurrence From Ductal Carcinoma in Situ
Receptor Proteins, Oncogenes, Tumor Suppressor Genes, and Ploidy
Special Types of Ductal Carcinoma in Situ With Special Implications
Pathology of Lobular Carcinoma in Situ
Acknowledgment
References
10 Infiltrating Carcinomas of the Breast
Molecular Classification
Histopathologic Classification
Histologic Types of Invasive Carcinoma
Prognosis of Invasive Breast Carcinoma
Prognostic Profiles in Breast Cancer
Predictive Profiles in Breast Cancer
Conclusion and Shortcomings of the Current System
References
9
11 Mesenchymal Neoplasms and Primary Lymphomas of the Breast
Mesenchymal Neoplasms of the Breast
Primary Breast Lymphoma
Acknowledgment
References
12 Paget Disease of the Breast
Pathogenesis
Histopathology
Clinical Presentation
Radiologic Findings
Management
Prognosis
References
13 Primary and Secondary Dermatologic Disorders of the Breast
Primary Breast Dermatologic Disorders
Secondary Breast Dermatologic Disorders
References
14 Breast Biomarker Immunocytochemistry
Estrogen Receptor: Historical Perspective
Progesterone Receptor: Historical Perspective
Receptor Status Assessment: Why Is It Important?
Scoring of Receptor Expression
10
American Society of Clinical Oncology/College of American
Pathologists Recommendations
Correlation With Oncotype Dx
Repeat Immunohistochemical Studies on Recurrent and Metastatic
Disease
Commonly Used Monoclonal Antibodies
Human Epidermal Growth Factor Receptor 2
Ki67 (Proliferation Marker)
E-Cadherin and p120
References
Section V Natural History, Epidemiology, Genetics,
and Syndromes of Breast Cancer
15 Epidemiology of Breast Cancer
Descriptive Epidemiology
Differences in Subtypes of Breast Cancer by Race, Ethnicity and
Geography
Sociodemographic Factors
Traditional Risk Factors for Breast Cancer
Other Risk Factors for Breast Cancer
References
16 Primary Prevention of Breast Cancer
Identifying Women at Risk
Chemoprevention
11
Chemoprevention Risk-Reduction Trials
Tamoxifen and Benign Breast Disease
SERMs in Lobular Carcinoma in Situ and Atypical Hyperplasia
Overall Risk of Developing Invasive Breast Cancer in Women With
Atypical Hyperplasia
Assessing Risks and Benefits of Tamoxifen for Chemoprevention
Indications and Contraindications for Risk Reduction With SERMs
Effect of Tamoxifen in Carriers of Predisposing Genetic Mutations
Clinical Monitoring of Women Taking Tamoxifen
Tamoxifen Metabolites
Clinical Data With Raloxifene
Study of Tamoxifen and Raloxifene Trial
Aromatase Inhibitors
Expert Recommendations on the Use of Pharmacologic Interventions
for Breast Cancer Risk Reduction
Summary
References
17 Breast Cancer Genetics
The Value of Genetic Testing
Role of the Cancer Genetics Counselor
Identifying Mutation Carriers
Genetic Testing Technology
Classifying Variants
Variants of Uncertain Significance
12
Multigene Panels
Managing Cancer Risk
Managing Cancer in Mutation Carriers
References
Section VI Prognostic Factors for Breast Cancer
18 Clinically Established Prognostic Factors in Breast Cancer
Nomenclature
Prognostic Factors
Predictive and Prognostic Factors
Summary
References
19 Molecular Prognostic Factors for Breast Carcinoma
Genomic Assays
Summary
References
20 Risk Factors for Breast Carcinoma in Women With Proliferative
Breast Disease
Nashville Breast Cohort Studies
Mayo Clinic Studies
Other Studies
Extent of Atypical Hyperplasia
13
Age, Family History, and Proliferative Disease
Complex Fibroadenoma and Proliferative Breast Disease
Effect of Time Since Biopsy on Risk of Breast Cancer
References
21 Steroid Receptors in Breast Cancer
Estrogen Receptor
The Progesterone Receptor
Androgen Receptor
Summary and Conclusions
References
Section VII Molecular Biology of Breast
Carcinogenesis
22 Molecular Oncology of Breast Cancer
Hallmarks of Cancer
Normal Mammary Development and Carcinogenesis
Molecular Profiling
Hereditary Breast Cancers
Molecular Profiles of Sporadic Breast Cancers
Biomarkers Used in Clinical Management of Breast Cancer
Conclusion
Acknowledgment
References
14
23 Stem Cells in Breast Development and Cancer
Stem Cells in the Normal Breast
Stem Cells in Breast Cancer
Acknowledgment
References
24 Therapeutic Strategies for Breast Cancer
Epidemiology of Breast Cancer
Breast Cancer Risk Factors
The Natural History of Breast Cancer
From Descriptive Models to Biologically Informed Carcinogenesis
Therapeutic Strategies for the Management of Invasive Breast Cancer
Conclusion and Future Directions
References
Section VIII Screening and Diagnosis of Breast
Disease
25 Examination Techniques
Breast Self-Examination
Clinical Breast Examination
Imaging Modalities
Invasive Diagnostic Procedures
References
15
26 Breast Imaging Screening and Diagnosis
Mammography
Ultrasound
Magnetic Resonance Imaging
Other Breast Imaging Technologies
Imaging-Guided Interventional Procedures
Staging and Imaging Follow-Up of Women With Breast Cancer
References
Section IX Clinical Trials: Biostatistical Applications
27 Design and Conduct of Clinical Trials for Breast Cancer
Evolving Ethics and Regulation of Clinical Trials in the United States
Research Versus Clinical Care
What Is Not a Clinical Trial
Why Do Clinical Trials?
Designing Clinical Trials
Types of Clinical Trials
Trial Design for Phase I Oncology Studies
Trial Design for Phase II Oncology Studies
Trial Design for Phase III Randomized Controlled Studies
Randomization Process
Sample Size Determination and Power Analysis
Monitoring Response Variables
16
Judging Quality of Clinical Trials: Level of Evidence
Reporting of Adverse Events for Clinical Trials
Conclusions
References
Section X Surgery for Benign and Malignant
Diseases of the Breast
28 Indications and Techniques for Biopsy
Fine-Needle Aspiration Biopsy
Direct Smear
Fluid Aspiration
Core Needle Biopsy
Open Surgical Biopsy
Conclusion
Acknowledgment
References
29 General Principles of Mastectomy
Topographic Surgical Anatomy
Evolution of Surgical Techniques for Mastectomy
Design of Incisions for Mastectomy in the Treatment of Breast Cancer
Skin-Sparing Mastectomy
Reconstruction Considerations
References
17
30 Halsted Radical Mastectomy
Historical Aspects for Development of Radical Mastectomy
Breast Cancer Treatment in the United States
Indications for Use of the Halsted Radical Mastectomy
Technique of Radical Mastectomy
References
31 Modified Radical Mastectomy and Simple Mastectomy
Modified Radical Mastectomy
Simple Mastectomy
Modified Radical Mastectomy Technique
References
32 Breast Conservation Therapy for Invasive Breast Cancer
Historical Perspective
Survival
Local Recurrence
Cosmetic Outcome
Patient Selection
Magnetic Resonance Imaging
Operative Technique
Axilla
Radiation Therapy
References
18
Section XI Breast Reconstruction
33 Breast Reconstruction and Oncoplastic Surgery
Role of Reconstruction in Breast Cancer Treatment
Definition of the Mastectomy Deformity
Reconstructive Surgical Methods
Conclusions
References
Section XII Complications of Breast Surgery
34 Wound Care and Complications of Mastectomy
Care of the Postmastectomy Wound
Complications of Mastectomy
References
35 Quality Measures and Outcomes for Breast Cancer Surgery
Why Measure Quality?
Who Are the Stakeholders for Quality Measurement?
What Is the American History of Surgical Quality Measurement?
What Are Quality and Value?
What Are Safety in Surgery and Diagnostic Errors?
How Do We Identify a Gap in the Quality of Care?
Where Are the Databases for Quality and Clinical Outcomes
Research?
19
How Do We Measure Quality?
What Is a Quality Measure, and Where Do We Find Them?
What Are the Quality Reporting Systems in the Public Sector?
What Is the Future of Public Quality Measurement Reporting?
How Do We Create the Best Quality Measures?
How Do We Rank a List of Many Quality Measures?
How Are Quality Measures Used?
How Do We Analyze Quality Data and Provide Fair Peer
Comparisons?
What Is a Benchmark?
How Do We Improve Quality?
Do Quality Measurement and Improvement Programs Work?
Have the Breast-Specific Quality Measurement Programs Improved
Breast Care?
What Are the Risks of Quality Measurement?
What Are the Future Challenges in Quality Measurement?
Conclusion
References
36 Lymphedema in the Postmastectomy Patient
History
Anatomy
Pathophysiology
Etiologic Risk Factors and Incidence
Lymphedema From Radiation Treatment
20
Classification
Patient History and Measurement of Lymphedema
Nonoperative Management of Lymphedema
Prevention of Lymphedema
Nonoperative Management of the Axilla
Axillary Reverse Mapping and Reanatomosis
Operative Management of Lymphedema
Lymphangiosarcoma: a Rare but Fatal Complication of Long-Standing
Lymphedema
Summary
Acknowledgment
References
Section XIII Current Concepts and Management of
Early Breast Carcinoma (Tis, Tmic, T1)
37 Assessment and Designation of Breast Cancer Stage
Staging: Past, Present, and Future
Clinical, Pathologic, and Biological Markers and Factors in Determining
Prognosis
Evolution of Staging Systems
Current Staging System
Extent and Multicentricity of In Situ and Invasive Carcinoma
Associated Factors
Clinical Implications of Multicentricity
21
Acknowledgment
References
38 Lobular Carcinoma in Situ of the Breast
Historical Background
LCIS Histopathology
Clinical Presentation, Natural History, and Biologic Significance of
LCIS
Female Steroid Hormones and LCIS
Endocrine Chemoprevention for LCIS
Surgical Intervention for LCIS
Conclusions
References
39 Ductal Carcinoma in Situ of the Breast
The Changing Nature of Ductal Carcinoma in Situ
Pathology
Detection and Diagnosis
Treatment
Prospective Randomized Ductal Carcinoma in Situ Trials
Tamoxifen for Ductal Carcinoma in Situ
Determination of HER2/neu Status and Potential Benefit of
Neoadjuvant Trastuzumab
Predicting Local Recurrence in Conservatively Treated Patients With
DCIS
Oncotype DX Breast DCIS Score
22
Sentinel Node Biopsy for Ductal Carcinoma in Situ
Summary
References
40 The New Paradigm
General Considerations
Preoperative Planning
Surgical Considerations
Oncoplastic Techniques
Extreme Oncoplasty
Summary
References
41 Therapeutic Value of Axillary Node Dissection and Selective
Management of the Axilla in Small Breast Cancers
Lymphatic Function and Nodal Metastases
Axillary Anatomy and Evaluation
Axillary Radiotherapy
Therapeutic Role of Axillary Node Dissection
Selective Management of Axilla
Targeted Axillary Lymph Node Dissection
References
42 Lymphatic Mapping and Sentinel Lymphadenectomy for Breast
Cancer
History of Sentinel Node Concept in Breast Cancer
23
Evolution of Dye-Directed Sentinel Lymphadenectomy for Breast
Cancer
Complete Nonsentinel Node Staging and Proof of Principle
Prospective Study of Sentinel Lymphadenectomy Alone for a Tumor-
Free Sentinel Node
Identification of the Sentinel Node in Breast Cancer by
Radiolocalization
Identification of the Sentinel Node With Preoperative
Lymphoscintigraphy and Intraoperative Radioguided Surgery
Combined Technique of Vital Dye and Radioisotope
Global Experience With Sentinel Lymphadenectomy in Breast Cancer
Multicenter Lymphatic Mapping Trials
Clinical, Pathologic, and Technical Aspects of Sentinel
Lymphadenectomy
Technical Considerations
Radiolocalization and Lymphatic Mapping With Isotopes
Histopathologic Evaluation
Morbidity of Sentinel Lymphadenectomy
Learning Curve
Prospective Randomized Clinical Trials
Summary
References
43 Detection and Significance of Axillary Lymph Node
Micrometastases
Definition and Classification of Axillary Lymph Node Micrometastases
The Ludwig Studies of Axillary Lymph Node Micrometastases
24
Logistical Hurdles in the Detection of Axillary Lymph Node
Micrometastases
Role of Enhanced Pathology in Sentinel Lymph Node Biopsy
Prognostic Significance of IHC-Detected Micrometastases: Prospective
Studies
Surgery for SLN Micrometastases: A Shifting Paradigm
Unresolved Controversies
Conclusions and Future Directions
References
44 Intraoperative Evaluation of Surgical Margins in Breast
Conserving Therapy
Frequency of Margin-Positive Partial Mastectomy
Pathologic Assessment of Margin Status and Specimen Handling
Summary and Conclusions
References
45 Surgical Management of Early Breast Cancer
Preoperative Evaluation
Surgical Options for Early Breast Cancer
Breast Conservation Surgery
Mastectomy
Axillary Evaluation
Adjuvant Radiotherapy
Outcome After Surgical Management of Breast Cancer
Minimally Invasive Ablative Therapies
25
Radiofrequency Ablation
Cryoablation
Interstitial Laser Therapy
Microwave Ablation
Irreversible Electroporation
Summary
References
Section XIV Therapy for Stages 0, I, and II Breast
Cancer
46 Biological Basis of Radiotherapy of the Breast
Radiotherapy Techniques: Introduction
Radiation Therapy Modalities: External Beam Versus Brachytherapy
Radiobiological Considerations
Anatomic Considerations for Radiation Delivery
External-Beam Techniques and Considerations
Cardiac Avoidance in Breast Radiotherapy Planning
Accelerated Partial Breast Irradiation
Conclusions
References
47 Radiotherapy and Ductal Carcinoma in Situ
Randomized Trials Demonstrate Efficacy of Radiotherapy for
Treatment of DCIS
26
Results With Excision Alone in Selected Patients
Factors Associated With Local Recurrence
Tools to Predict Risk
Tamoxifen and Radiotherapy
Radiation Treatment Techniques
Patterns of Recurrence and Results of Salvage Treatment
Radiation Therapy After Mastectomy
Conclusions
References
48 Radiotherapy and Regional Nodes
Patient Selection
Radiotherapy Techniques for Regional Nodes
References
49 Postmastectomy Radiotherapy
Randomized Trials of Postmastectomy Radiotherapy
Controversies Surrounding Application of Randomized Trial Data in N1
Disease
Special Considerations
Tumor Biology Considerations
Postmastectomy Radiotherapy and Reconstructive Surgery
Conclusions
References
50 Breast Conserving Therapy for Invasive Breast Cancers
27
Randomized Trials Comparing Breast Conserving Surgery and
Radiation Therapy With Mastectomy
Patient Selection for Breast Conserving Surgery and Radiation
Patient Selection Factors for Hypofractionated Whole Breast Irradiation
Timing of Radiation Therapy in Relation to Surgery and Systemic
Therapy
Characteristics and Management of Local Failure After Breast
Conserving Surgery and Radiation Therapy
Breast-Conserving Surgery Without Radiation Therapy
Conclusions
References
51 Partial Breast Irradiation
Accelerated Partial Breast Irradiation
Intraoperative Radiation Therapy
Conclusions
References
52 Radiation Complications and Their Management
Fatigue and Myelosuppression
Radiation Dermatitis and Infections
Cosmesis and Breast-Related Symptoms
Rib Fracture
Brachial Plexopathy
Pulmonary Complications
Cardiac Complications
28
Second Malignancies
Complications in Patients With Collagen Vascular Disease
Conclusions
References
53 Radiation Therapy for Locally Advanced Breast Cancer
Definition
Incidence
Outcomes
General Treatment Paradigms
Rationale for Use of Systemic Therapy
Rationale for Postmastectomy Radiation
Locoregional Recurrence Rates Without PMRT
Guideline Statements for PMRT and LABC
Studies for LABC
RT Alone for Operable LABC
Neoadjuvant Chemotherapy Followed by Either Resection or Radiation
Resection Followed by Systemic Therapy and Either Observation or
Radiation
Neoadjuvant Systemic Therapy and Radiation for LABC
Inoperable LABC
Inflammatory Breast Carcinoma
Role for PMRT After NAC and Mastectomy
Potential Option for BCS After NAC for LABC
Locoregional Recurrence Risk on NSABP Trials of NAC and
29
Implications for RT
Other Prognostic Factors and Future Directions
Locoregional Radiation Targets and Techniques for LABC
Conclusion
References
54 Adjuvant Endocrine Therapy
Rationale for Adjuvant Endocrine Therapy
Who Is a Candidate for Adjuvant Endocrine Therapy?
Adjuvant Endocrine Therapy: Mechanism of Action
Approaches to Adjuvant Endocrine Therapy for Invasive Early-Stage
Breast Cancer
Timing of Initiation of Adjuvant Endocrine Therapy
Moving Beyond Hormone Receptor Status: Biomarkers to Guide
Therapeutic Decisions in Women With Invasive Early-Stage Hormone
Receptor–Positive Breast Cancer
Approaches to Adjuvant Endocrine Therapy for Ductal Carcinoma in
Situ
Common Side Effects of Adjuvant Endocrine Therapy
Adherence to Adjuvant Endocrine Therapy
Conclusion
References
55 Adjuvant and Neoadjuvant Systemic Therapies for Early-Stage
Breast Cancer
Adjuvant Chemotherapy
First-Generation Regimens
30
ER-Positive Disease
Bisphosphonates in ER-Positive Breast Cancer
HER2-Positive Disease
Neoadjuvant Therapy
References
56 HER2-Positive Breast Cancer
HER2 Biology
HER2 Pathology
HER2-Targeted Therapy
Future Directions in HER2-Targeted Therapy
References
57 Bisphosphonates in Early Breast Cancer
Bisphosphonates: Mechanism of Action
Types of Bisphosphonates
Rationale for an Anticancer Effect for Bisphosphonates
Clinical Trials on Adjuvant Bisphosphonates in Breast Cancer
Individual Patient-Level Data Meta-Analysis
Rationale for Bisphosphonate Benefit in Postmenopausal Women
Safety of Adjuvant Bisphosphonates
When to Consider Adjuvant Bisphosphonates
Conclusions
References
31
58 Oncofertility Options for Young Women With Breast Cancer
Oogenesis and Assessing Ovarian Reserve
Gonadotoxicity of Cancer Therapies in Reproductive-Age Women
Fertility Preservation Options
Contraception and Cancer Therapy
Female Sexuality After Cancer Therapy
Pregnancy in Cancer Patients and Survivors
Talking With Patients and Families About Future Fertility
Oncofertility in Clinical Practice
Acknowledgment
References
Section XV Management of Advanced Local,
Regional, and Systemic Disease
59 Surgical Procedures for Advanced Local and Regional
Malignancies of the Breast
Staging System Revisions and Implications
Pretreatment Evaluation, Diagnosis, and Management
Unimodal Treatment Approaches
Multimodal Approaches
Breast Conserving Surgery in Locally Advanced Breast Cancer
Axillary Staging
Timing of Therapies
32
Full-Thickness Chest Wall Resection Revisited
Reconstructive Techniques
Options for Chest Wall Closure
Full-Thickness Chest Wall Defects and Prosthetic Materials
Radiotherapy and Reconstruction
Multidisciplinary Approach
Algorithm for Chest Wall Reconstruction
References
60 Solitary Metastases
Liver
Lung
Bone
Brain
Summary
References
61 Locoregional Recurrence After Mastectomy
Definitions
Incidence
Detection and Diagnosis
Survival After Locoregional Recurrence
Local Treatment
Radiation Therapy
Systemic Therapy
33
Conclusion
References
62 Principles of Preoperative Therapy for Operable Breast Cancer
Coming of Age for Preoperative Systemic Therapy in Operable Breast
Cancer
Rationale for Preoperative Systemic Therapy
Patient Selection for Preoperative Therapy in Operable Breast Cancer
Delivery of Optimal Preoperative Systemic Therapy
Conclusions
References
63 Locally Advanced Breast Cancer
Epidemiology
Survival
Diagnosis and Staging
Prognostic Factors
Evolution of Local Therapy
Combined Modality Treatment
Neoadjuvant Chemotherapy
Neoadjuvant Anti-HER2-Based Therapy
Neoadjuvant Antiestrogen Therapy
Assessment of Response to Neoadjuvant Chemotherapy
Predictors of Response to Neoadjuvant Therapy
Breast Conserving Surgery
34
Management of the Axilla: Historical Perspective and Current
Recommendations
Treatment Summary
References
64 Inflammatory Breast Cancer
Introduction and Historical Backdrop
Epidemiology
Diagnosis
Medical Management and Trials
Surgical Management
Radiation Management
Metastatic Disease
Conclusion
References
65 Neoadjuvant Chemotherapy and Radiotherapy
Molecular Subtypes of Breast Cancer and Response to Neoadjuvant
Chemotherapy
Eligibility for Neoadjuvant Chemotherapy or Neoadjuvant Radiation
Therapy
Evaluation of Candidates for Neoadjuvant Chemotherapy or
Neoadjuvant Radiation Therapy
Outcomes and End Points of Neoadjuvant Therapy
Neoadjuvant Chemotherapy by Breast Cancer Subtypes
Targeted Therapy
Antiangiogenic Therapy
35
Neoadjuvant Radiation Therapy for Breast Cancer
Response Assessment After Neoadjuvant Chemotherapy
Surgical Management After Neoadjuvant Chemotherapy
Staging the Axilla and Sentinel Lymph Node Procedure
Chemotherapy After Surgery
Radiation Therapy After Neoadjuvant Systemic Therapy
The Neoadjuvant Setting for Research and Drug Development
Conclusion and Future Directions
References
66 Detection and Clinical Implications of Occult Systemic
Micrometastatic Breast Cancer
Gene Expression Profiling of Breast Cancer Cells
Cancer Stem Cells
Methods for Analysis of CTCs
Clinical Applications of CTCs
Role of CTCs as a “Liquid Biopsy” in Metastatic Disease
Conclusions and Future Directions
References
67 Management of the Intact Breast Primary in the Setting of
Metastatic Disease
Retrospective Analyses of Primary Site Local Therapy
Randomized Prospective Trials
Who Should Be Offered Locoregional Therapy
Conclusion
36
References
68 Management of Bone Metastases in Breast Cancer
Pathophysiology
Clinical Presentation
Diagnosis
Surgical Management
Radiotherapy
Systemic Osteoclast Inhibitors
New Treatment Modalities
Conclusions and Recommendations
Acknowledgment
References
69 Chemotherapy and HER2-Directed Therapy for Metastatic
Breast Cancer
Epidemiology
Therapeutic Goals
Prognostication
Medical Evaluation in the Metastatic Setting
Local Therapy for Metastatic Breast Cancer
Selecting Therapy for Metastatic Breast Cancer
Chemotherapy for Metastatic Breast Cancer
Novel Agents in Metastatic Breast Cancer
Historical Treatments for Metastatic Breast Cancer
37
Treatment of Metastatic Bone Disease
Special Considerations
Monitoring Response to Therapy
Future of Systemic Therapy for Metastatic Breast Cancer
References
70 Endocrine Therapy for Breast Cancer
History of Endocrine Therapy in Breast Cancer
General Strategies for Targeting the Hormonal Axis
Key Therapeutic Agents
Ductal Carcinoma in Situ
HR-Positive Invasive Breast Cancer: Adjuvant Treatment
Advanced and Metastatic Breast Cancer: Treatment
References
71 Immunologic Approaches to Breast Cancer Therapy
Immunity and Breast Cancer
Diagnostic Role of Tumor-Associated Autoantibodies
Prognostic Role of Tumor-Infiltrating Lymphocytes
Immunologic Effects of Standard Breast Cancer Therapies
Breast Cancer Vaccines
Adoptive T-Cell Therapy
Immune Checkpoint Inhibitor Therapy
Immuno-Prevention of Breast Cancer
Conclusion
38
Acknowledgments
Conflict of Interest
References
72 Diagnosis and Management of Pleural Metastases and Malignant
Effusion in Breast Cancer
Pathogenesis
Clinical Presentation
Diagnosis
Treatment: Indications, Approaches, and Complications
Prognosis
Summary
References
73 Management of Central Nervous System Metastases in Breast
Cancer
Incidence
Risk Factors
Methods of Spread and Distribution
Clinical Presentation
Diagnostic Evaluation
Treatment
References
74 Management of Pericardial Metastases in Breast Cancer
Pericardial Effusion in Breast Cancer
39
Pericardial Constriction in Breast Cancer
References
Section XVI Special Presentations of Breast Cancer
75 Bilateral Breast Cancer
Risk Factors for Bilateral Breast Cancer
Impact of Advanced Imaging and Adjuvant Therapy on Bilaterality
Prognosis of Bilateral Breast Cancer
Contralateral Prophylactic Mastectomy
Recommendations and Future Directions
References
76 Male Breast Cancer
Epidemiology
Risk Factors
Clinical Features
Diagnosis
Pathology
Treatment of Localized and Locally Advanced Disease
Treatment of Metastatic Disease
Prognosis
Survivorship Issues and Surveillance
Management Summary
References
40
77 Local Recurrence, the Augmented Breast, and the Contralateral
Breast
Locoregional Recurrence After Mastectomy
Recurrence in the Reconstructed Breast
Recurrence After Breast Conserving Therapy
Breast Cancer in the Augmented Breast
Breast Cancer After Skin-Sparing Mastectomy
Cancer Risk in the Contralateral Breast
References
78 Carcinoma of the Breast in Pregnancy and Lactation
Prognosis and Historical Perspective
Diagnostic Evaluation and Staging During Pregnancy
Treatment
Special Issues
Conclusion
References
79 Unknown Primary Presenting With Axillary Lymphadenopathy
Incidence
Diagnosis
Management
References
80 Clinical Management of the Patient at Increased or High Risk
41
Breast Cancer Risk Assessment
Risk Assessment Models Based on Nongenetic Factors
Risk Assessment Models Based on Family History and Genetic
Factors
Nongenetic Breast Cancer Risk Counseling
Genetic Breast Cancer Risk Counseling
High-Risk Women Secondary to Premalignant Lesions and Elevated
Gail Risk
High-Risk Women Secondary to Genetic Predisposition
High-Risk Women Secondary to Elevated Gail Risk, Prior Thoracic
Radiation at an Early Age, or Premalignant Lesions
High-Risk Women Secondary to Known or Suspected Genetic
Predisposition
Conclusions
References
Section XVII Survivorship, Follow-Up Care, and
Rehabilitation of the Breast Cancer Patient
81 General Considerations for Follow-Up
Surveillance for Locoregional Recurrences or New Primary Disease
Detecting Distant Relapse
Managing Long-Term and Late Effects of Cancer Treatment
Non–Cancer-Related Care
Survivorship Care Planning
Conclusions and Future Directions
42
References
82 Management of Menopause in the Breast Cancer Patient
What Is the Experience of Menopause in Women With Breast Cancer?
Is Hormone Therapy an Option for Women With Breast Cancer?
Alternatives to Estrogen-Based Therapy for Management of Vasomotor
Symptoms
Are Topical Estrogens an Option for Women With Breast Cancer?
Alternatives to Topical Estrogens for Vulvovaginal Atrophy
Depression
Osteoporosis
Cardiovascular Disease
Conclusions
References
83 Rehabilitation
Deconditioning
Fatigue
Upper Quadrant Dysfunction
Neuropathy
Pain
Exercise
Cognitive Dysfunction
Vocational Rehabilitation
Conclusion
43
Acknowledgment
References
84 Psychosocial Consequences and Lifestyle Interventions
Psychosocial Aspects of Breast Cancer
Distress in Breast Cancer
Lifestyle and Breast Cancer
Conclusion
Acknowledgments
References
85 Breast Cancer Survivorship
Background
Identification and Management of Late and Long-Term Effects of
Breast Cancer and Treatment
Fatigue
Cognition
Cardiac Dysfunction
Sexual Health, Body Image, and Relationship Issues
Psychosocial Issues and Healthy Lifestyle
Fertility and Menopause
Understanding Cancer Risk and Management Strategies
Imaging and Breast Cancer Survivors
Development of Breast Cancer Survivorship Care: Program
Development and Outcomes
Conclusions
44
References
Section XVIII Medical and Legal Issues Specific to
the Care of Breast Cancer
86 Delayed Diagnosis of Symptomatic Breast Cancer
Magnitude of the Problem
Definition of Delayed Diagnosis of Breast Cancer
Patient-Associated Delays in Diagnosis
Physician-Associated Delays in Diagnosis
Influence of Delayed Diagnosis of Breast Cancer on Survival
Conclusion: How to Prevent the Delayed Diagnosis of Breast Cancer—
Synopsis of Clinical Risk Prevention
References
Index
The Breast Comprehensive Management of Benign and Malignant Diseases 5th Edition PDF Ebook

Kirby I. Bland, MD
Professor and Chair Emeritus
Department of Surgery
University of Alabama at Birmingham
Birmingham, Alabama

Edward M. Copeland III, MD
Emeritus Distinguished Professor
Department of Surgery
University of Florida College of Medicine
Gainesville, Florida

V. Suzanne Klimberg, MD, PhD
The Courtney M. Townsend, Jr., M.D. Distinguished Chair in General
Surgery
Vice Chair for Administration
Professor of Surgery
University of Texas Medical Branch
Galveston, Texas

William J. Gradishar, MD
Betsy Bramsen Professor of Breast Oncology
Professor, Department of Medicine-Hematology/Oncology
Northwestern University Feinberg School of Medicine
Chicago, Illinois