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Axillary dissection (AD) has been part of breast cancer surgery from the time of Halsted. The status of the axillary nodes remains the most powerful prognostic indicator in the treatment of invasive breast cancer. Debate…

Breast reconstruction is an integral part of the surgical treatment of breast cancer. Reconstructive options are part of the discussion with a patient if mastectomy is being considered. It is a central component of the…

Historically, DCIS comprised about 3% of breast cancers, and most cases were large palpable tumors. Recently, an increasing portion of patients present with impalpable DCIS. Up to one-third of breast cancers found on…

The treatment options for patients with early-stage (Stage I and II) invasive breast cancer today are breast-conservation therapy (BCT) with adjuvant radiation therapy and modified radical mastectomy (MRM) with or without breast…

Surgery is the most effective treatment option ever employed against breast cancer. Halsted’s radical mastectomy (RM), which dates from the turn of the century, revolutionized the local control of the disease and…

Breast imaging plays an integral role in breast cancer screening and diagnosis. Screening mammography is performed in an asymptomatic woman in order to detect clinically occult breast carcinoma. Diagnostic mammography is performed to evaluate a…

Breast imaging plays a critical role in breast screening and diagnosis.

Screening and diagnostic mammography allow the detection and evaluation of clinically occult breast cancer. The mammogram report should be worded n accordance…

Stereotactic biopsy uses specialized mammography equipment to calculate precisely the location of a lesion in three dimensions. Stereotactic biopsy can be performed with the patient prone on a dedicated table or with the patient sitting…

The goals of needle localization are to assist the surgeon in removing a nonpalpable breast mass that is suspicious or highly suggestive of malignancy and to minimize the amount of tissue that must be sacrificed…

The Breast Imaging Reporting and Data System (BI-RADS™) lexicon was developed by the American College of Radiology (ACR) in an effort to standardize terminology used…

Abnormalities found on mammographic screening may need further evaluation with additional mammographic views or other imaging modalities, such as ultrasound or magnetic resonance imaging (MRI). In some screening programs, the mammograms are reviewed by the…

As breast cancer increases in size, there is a higher frequency of axillary metastases and a higher mortality rate. Tumor size for infiltrating breast carcinomas has been classified as T1 (<2 cm), T2 (2-5 cm),…

Some of the earliest randomized trials in all of clinical medicine, conducted in the 1950s, tested the use of radiation therapy (RT) in patients with invasive…

Women who have breasts that appear dense on a mammogram are at increased risk for breast cancer. The reason for the increase in risk is unknown. Denser breasts may…

Breast cancer is one of the most prevalent malignancies among women in the western world. Well-designed scientific trials in the diagnosis and management of this disease remain paradigms for investigators in all fields.

Among the sites of systemic failure most prevalent in patients with breast cancer, brain and bone metastases are very adequately treated with brief courses of radiation. In certain circumstances, surgical excision of a…

Among patients who experience failure within the treated breast after breast-conservation therapy, mastectomy is the standard of care. When there has been a considerable disease-free interval between the treatment of the primary tumor…

Two important changes have occurred over the last decade in the definition of locally advanced breast cancer.  First, T3N0 lesions have now been categorized as Stage IIB disease, reflecting their…

NSABP-B04 demonstrated that radiation, in lieu of axillary dissection, for patients with clinical N0 or N1 breast cancer was adequate treatment and secured local control in the majority of patients.

Currently, most…

During the course of therapy, patients commonly experience erythema, irritation and tenderness of the treated breast. Occasionally, there is blistering in the inframammary and anterior axillary region. Our policy on skin care is…

Six randomized trials, both in the United States and Europe, demonstrated conclusively that lumpectomy followed by radiation therapy to the conserved breast tissue was as effective as modified radical mastectomy in…

Breast cancer was the first major malignancy demonstrated to be adequately treated with organ preservation. The impact of the randomized trials performed in the United States and Europe to investigate the effectiveness…

In summary, the identification of a germline BRCA mutation in a woman with breast or ovarian cancer should not, at present, influence her local or systemic treatment. The recognition of a hereditary breast…

Given the uncertain utility of screening programs (secondary prevention) in this high-risk population, some women consider undergoing surgical procedures in an attempt to manage their risk. Bilateral risk-reducing…