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Showing Results for breast-conserving surgery
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Cancer: Principles & Practice of Oncology
Cancer: Principles & Practice of Oncology
Chapter 106. Malignant Tumors of the Breast >
Absolute and Relative Contraindications to Breast-Conserving Therapy
In the selection of patients for BCT, there are some absolute and relative contraindications.59 ...
Cancer: Principles & Practice of Oncology
Cancer: Principles & Practice of Oncology
Chapter 106. Malignant Tumors of the Breast >
Conservative Surgery without Radiation Therapy
An unresolved question is whether RT is necessary in all patients with invasive breast cancer after CS. It is well known that RT after CS reduces local recurrence by about ...
Cancer: Principles & Practice of Oncology
Cancer: Principles & Practice of Oncology
Chapter 106. Malignant Tumors of the Breast >
Breast-Conserving Therapy (updated 3/26/2012)
The goal of BCT using conservative surgery (CS) and RT is to provide survival equivalent to mastectomy with preservation of the cosmetic appearance and a low rate of recurrence in ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 52. Breast: Stage Tis >
Breast Conservation for DCIS
Three prospective randomized studies of excision only versus excision plus breast irradiation for DCIS have been performed, and all have shown that the rate of local recurrence was reduced with ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Breast-Conserving Surgery without Radiation
Based on the mature data from the well-conducted randomized trials outlined above and on long-term follow-up from the several large retrospective series, it is apparent that breast-conserving surgery followed by ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Breast-Conserving Therapy: Controversies and Special Circumstances
The available evidence from all of the retrospective and prospective trials above suggests that although there are clearly cohorts of patients who are at increased risk of local relapse, there ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Breast-Conserving Therapy and Patient Selection
Breast-conserving surgery followed by radiation therapy to the intact breast is now clearly established as the most acceptable standard of care for the majority of women with early stage invasive ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Randomized Studies Comparing Breast-Conserving Surgery Plus Radiation Therapy to Mastectomy
There have been numerous randomized trials that have clearly established breast-conserving surgery followed by radiation therapy as equivalent to mastectomy for appropriately selected patients with early stage breast cancer. Table ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Randomized Trials
Selected trials comparing breast-conserving surgery alone to breast-conserving surgery with radiation are summarized in Table 53.25. ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Conservative Surgery Alone in Elderly Women
The available evidence clearly establishes lumpectomy followed by radiation as the standard of care for the majority of women with early stage invasive breast cancer. As noted in the numerous ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Breast-Conserving Surgery and Radiation in Familial Breast Cancer and Carriers of BRCA1-2 Mutations
There is considerable controversy and uncertainty regarding the role of breast-conserving surgery and radiation in carriers of BRCA1-2 mutations (11,312,623). It has been just over a decade since these two ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Follow-Up of Patients Treated with Breast-Conservation Surgery and Irradiation
It is important to closely monitor patients treated with conservation surgery and irradiation because early detection of a local recurrence may allow for another wide local excision or a total ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 53. Early Stage Breast Cancer >
Radiographic Findings after Breast-Conservation Therapy
Dershaw (155) summarized the most frequent mammographic findings: parenchymal distortion and fibrosis at the tumor excision site (secondary to surgical scar and irradiation), skin thickening, seen in 90% of patients, ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 54. Breast Cancer: Locally Advanced and Recurrent Disease, Postmastectomy Radiation, and Systemic Therapies >
Breast Conservation Therapy after Neoadjuvant Chemotherapy
As noted, one of the potential benefits of neoadjuvant chemotherapy is that a large primary tumor will respond favorably to neoadjuvant chemotherapy, thereby rendering the disease amenable to a breast ...
Perez and Brady’s Principles and Practice of Radiation Oncology
Perez and Brady’s Principles and Practice of Radiation Oncology
Chapter 54. Breast Cancer: Locally Advanced and Recurrent Disease, Postmastectomy Radiation, and Systemic Therapies >
Recurrence in the Breast after Breast Conservation Therapy
Mastectomy remains the standard salvage treatment for disease that recurs in the breast after breast-conserving treatment. Most such patients will have been previously treated with breast irradiation and therefore would ...
Diseases of the Breast
Diseases of the Breast
Chapter 5. Management of the Palpable Breast Mass >
The Patient with a Personal History of Cancer
The patient who has a history of breast cancer has usually undergone either breast-conserving therapy (BCT) or mastectomy. In those women who have had BCT, surgical scarring and radiation-induced changes ...
Diseases of the Breast
Diseases of the Breast
Chapter 12. Imaging Analysis: Mammography >
Breast-Conservation-Treated Patient Surveillance
Mammographic surveillance following breast conservation therapy (BCT) is typically performed at 6 months, 12 months, and then yearly, although variations exist and the optimal intervals have not been established. Because ...
Diseases of the Breast
Diseases of the Breast
Chapter 25. Lobular Carcinoma In Situ: Clinical Management >
Breast-Conserving Therapy in the Presence of Lobular Carcinoma In Situ
Because LCIS is a marker of diffuse and bilateral proliferative activity in the breast, the presence of LCIS coexisting with invasive cancer provokes questions regarding the oncologic safety of breast-conservation ...
Diseases of the Breast
Diseases of the Breast
Chapter 26. Ductal Carcinoma In Situ and Microinvasive Carcinoma >
Excision and Radiation Therapy
Four randomized clinical trials have assessed the benefit of RT after excision in patients with DCIS (38,39,40,41) (Table 26.1). The first of these, National Surgical Adjuvant Breast and Bowel Project ...
Diseases of the Breast
Diseases of the Breast
Chapter 26. Ductal Carcinoma In Situ and Microinvasive Carcinoma >
Breast-Conserving Surgery Alone
In spite of the four prospective, randomized trials that have demonstrated that the addition of RT to excision significantly decreases IBTR, interest persists in treatment of some subsets of women ...
Diseases of the Breast
Diseases of the Breast
Chapter 36. Mastectomy >
Absolute and Relative Contraindications
Despite these findings, many women choose or must undergo mastectomy. Absolute contraindications to breast-conserving therapy include multicentric breast cancer (tumors in more than one quadrant) or diffuse malignant appearing microcalcifications. ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Breast Conservation as an Alternative to Mastectomy
After the advent of mammographic screening and increased public awareness, patients began presenting with early stage tumors and single institutions began pilot studies investigating breast-conserving surgery and radiation therapy as ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Role of Radiation in Breast Conservation
Radiation treatments play a critical role in successful breastconservation therapy for patients with invasive breast cancer. It has been clearly demonstrated that radiation treatment of the ipsilateral breast reduces the ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Selection Criteria For Breastconservation Therapy
Breast-conservation therapy is generally reserved for patients with tumors smaller than 4 cm. However, more important than absolute tumor size is the relationship between tumor size and breast size. The ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Postoperative Surveillance
In patients who are treated with breast-conserving surgery and postoperative radiation therapy, a new baseline mammogram of the treated breast is obtained 4 to 6 months after the completion of ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Management Summary
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Patient-, Disease-, and Treatment-Related Factors Associated with Local Outcome after Breast-Conservation Therapy
Patients treated with breast-conservation therapy have excellent rates of local control. The EBCTCG meta-analysis of the first generation of clinical trials investigating breast conservation reported a 5-year in-breast recurrence rate ...
Diseases of the Breast
Diseases of the Breast
Chapter 37. Breast-Conserving Therapy: Conventional Whole Breast Irradiation >
Surgical Technique
The surgical incision should be placed as close to the primary tumor as possible. In the case of nonpalpable tumors that can be visualized with sonography, preoperative needle localization with ...
Diseases of the Breast
Diseases of the Breast
Chapter 43. Axillary Irradiation >
Use of Tangential Breast Irradiation Alone in cNO Breast-Conserving Therapy Patients
Several studies have demonstrated low axillary recurrence rates in the setting of breast-conserving surgery and tangential breast irradiation (Table 43.3) without a specific axillary therapy in certain subsets of breast ...
Diseases of the Breast
Diseases of the Breast
Chapter 60. Local-Regional Therapy Considerations in Patients Receiving Preoperative Chemotherapy >
Surgical Management of the Primary Breast Tumor after Preoperative Chemotherapy
One clear clinical advantage of preoperative chemotherapy in women with large primary tumors, or in those with moderate size tumors but large tumor size to breast size ratio, is the ...
Diseases of the Breast
Diseases of the Breast
Chapter 61. Locally Advanced Breast Cancer >
Considerations for Breast-Conserving Surgery
The use of NACT has become standard management for patients with LABC, in part because it frequently reduces the size of the primary tumor enough to allow previously inoperable tumors ...
Diseases of the Breast
Diseases of the Breast
Chapter 65. Phyllodes Tumors >
Breast Conservation versus Mastectomy
In the M.D. Anderson experience of 101 patients with phyllodes tumors (2), surgery included local excision with breast conservation (47%) or mastectomy (53%). Microscopic surgical margins were negative in 99% ...
Diseases of the Breast
Diseases of the Breast
Chapter 66. Paget's Disease >
Breast Conservation without Radiation
Breast conservation alone leads to a high local failure rate and is not recommended. Several series published have reported high local recurrence rates with central lumpectomy alone. Polgar et al. ...
Diseases of the Breast
Diseases of the Breast
Chapter 66. Paget's Disease >
Breast Conservation with Radiation
If breast conservation is to be considered, the gold standard should be a central lumpectomy with postoperative radiation therapy (Figs. 66.6, 66.7, 66.8). The addition of radiotherapy has improved the ...
Diseases of the Breast
Diseases of the Breast
Chapter 72. Local-Regional Recurrence after Breast-Conservation Treatment or Mastectomy >
Local Recurrence after Breast Conservation Treatment
Diseases of the Breast
Diseases of the Breast
Chapter 72. Local-Regional Recurrence after Breast-Conservation Treatment or Mastectomy >
Breast-Conservation Surgery
Whether salvage mastectomy results in superior long-term survival rates for patients with local failure following initial breast-conservation treatment compared to treatment with lesser surgical procedures is unclear. However, salvage mastectomy ...
Diseases of the Breast
Diseases of the Breast
Chapter 95. Psychosocial Adaptation During and After Breast Cancer >
Breast-conserving Therapy (Lumpectomy and Irradiation)
Until recently, the number of women undergoing breast-conserving therapy (BCT) steadily increased; however, in many areas of the country, the use of mastectomy has recently begun to increase. A significant ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 15. Cancer and Pregnancy >
Breast-Conserving Therapy
Previously, women diagnosed with pregnancy-associated breast cancer were treated universally with modified radical mastectomy. Mastectomy eliminates the need for whole-breast radiation, which is contraindicated during all stages of pregnancy. More ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 17. Breast Cancer: Ductal Carcinoma in Situ: >
Breast Conservation
The most recently available Surveillance Epidemiology and End Results (SEER) data reveal that 72% of patients with DCIS are treated with breast conservation. Although breast conservation is now widely accepted ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Breast-Conserving Therapy
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Expanding Eligibility for Breast-Conserving Therapy
Based on the patient selection criteria and contraindications to BCT described elsewhere in this chapter, most women with early-stage breast cancer will be eligible for BCT. However, some will not ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Figure 18.3. Patient Involvement in Surgical Decision Making
In spite of the large body of evidence discussed earlier in this chapter, supporting the use of BCT for stage I and II breast cancer, mastectomy remains a common approach ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Commentary
Over 200,000 women will be diagnosed with breast cancer each year in the United States and the majority of women will have multiple options with respect to the surgical treatment ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Clinical Trials
In the past, a major objection to the use of BCT was the known multicentricity of breast cancer. The reported incidence of multicentricity ranges from 9% to 75% (1–3), depending ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Contraindications to Breast-Conserving Therapy
The majority of patients with early-stage breast cancer are eligible for BCT. Absolute and relative contraindications to BCT have been defined, and regularly updated, by a joint committee of the ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer >
Patient Selection for Breast-Conserving Therapy
As is apparent from the previous discussion, BCT is a procedure with well-defined contraindications that have traditionally been identified with a history, physical examination, and diagnostic mammography with or without ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 19. Radiation Therapy in Breast-Conserving Therapy for Invasive Breast Cancer >
Patient Selection
Criteria for selecting patients for breast-conservation surgery followed by breast radiation include factors used in the original clinical trials as well as guidelines developed by the American College of Radiology ...
Cancer: Principles & Practice of Oncology
Cancer: Principles & Practice of Oncology
Chapter 106. Malignant Tumors of the Breast > Local Management of Invasive Cancer
Patients with T4 tumors and those with N2 nodal disease ...
Principles and Practice of Gynecologic Oncology
Principles and Practice of Gynecologic Oncology
Principles and Practice of Gynecologic Oncology
Principles and Practice of Gynecologic Oncology
Chapter 29. Breast Cancer > Sequelae Of Treatment
Of the late effects of radiation treatment in a woman ...
Diseases of the Breast
Diseases of the Breast
Chapter 19. Genetic Testing and Management of Patients with Hereditary Breast Cancer > Local Treatment
Although the increased risk of contralateral breast cancer in
Diseases of the Breast
Diseases of the Breast
Chapter 26. Ductal Carcinoma In Situ and Microinvasive Carcinoma > Treatment Selection in Ductal Carcinoma In Situ
Needle localization should be used to guide the surgical excision; ...
Diseases of the Breast
Diseases of the Breast
Chapter 40. Local Therapy for the Breast and Chest Wall > Introduction
A high percent of patients presenting with stage I or ...
Principles and Practice of Surgical Oncology
Principles and Practice of Surgical Oncology
Chapter 18. Surgical Options for Stage I and II Breast Cancer > Commentary
The issue of margins for breast-conserving surgery is one that ...
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