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Surgical Clinics of North America

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https://www.readbyqxmd.com/read/30005782/management-of-breast-cancer
#1
EDITORIAL
Catherine C Parker
No abstract text is available yet for this article.
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005781/foreword
#2
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005780/sarcomas-of-the-breast
#3
REVIEW
Mallory A Duncan, Meeghan A Lautner
Sarcoma of the breast is extremely rare and differs from epithelial breast carcinomas in staging and treatment. Diagnostic workup includes breast imaging and core biopsy as in breast epithelial carcinoma. Surgical management is often wide local excision in the form of breast conservation if possible for primary breast sarcoma or total mastectomy. Radiation-associated breast angiosarcomas often require total mastectomy with radical excision of skin. Breast sarcomas have a hematogenous spread so lymph node evaluation is not a part of treatment or staging...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005779/role-of-operative-management-in-stage-iv-breast-cancer
#4
REVIEW
Mediget Teshome
The role of operative therapy in stage IV breast cancer continues to evolve with advances in therapy and improvements in survival among this population. Traditionally surgery was performed with palliative intent to alleviate symptoms related to the intact breast primary. Several retrospective studies have challenged this paradigm, demonstrating survival advantage with surgery in de novo metastatic disease. Prospective studies are ongoing and maturing data. A comprehensive approach to local therapy following systemic therapy may be beneficial to achieve improved survival outcome associated with stage IV- no evidence of disease and to decrease local failure in inflammatory breast cancer...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005778/breast-reconstruction
#5
REVIEW
Hani Sbitany
Breast reconstruction is offered to women undergoing mastectomy or breast conservation, given its safe nature and highly aesthetic reconstructive outcomes. Breast implants are safe, offer flexibility of sizes and projections, and shorter recovery. Autologous flaps allow women to avoid prosthetic devices, using skin and fat to replace breast tissue. The increasing frequency of nipple-sparing mastectomy, autologous fat grafting, use of acellular dermal matrices, and prepectoral prosthetic reconstruction have enhanced aesthetic outcomes...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005777/evolution-of-operative-technique-for-mastectomy
#6
REVIEW
Caroline Jones, Rachael Lancaster
The radical mastectomy was the mainstay of breast cancer treatment through the majority of the twentieth century. However, as the understanding of breast cancer increased, the indications for more extensive surgical intervention decreased. The mastectomy has evolved so that skin-sparing or nipple-sparing mastectomy can be performed in the majority of women who undergo mastectomy currently. Today, nearly 40% of all women undergo mastectomy for breast cancer. The improved cosmetic appearance associated with skin- or nipple-sparing mastectomies does not compromise oncologic outcomes...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005776/breast-cancer-in-the-elderly
#7
REVIEW
Flora Varghese, Jasmine Wong
With increasing life expectancy and growth of the elderly US population, it becomes paramount that breast cancer research focuses more on the prevention, screening, and treatment of these patients. Age is no longer a cutoff for managing breast cancer in the elderly. Studies have shown the current undertreatment of cancer undermines survival, but the tide is turning to provide evidence-based medicine for the elderly. More often, clinicians and surgeons look not only at tumor-specific characteristics of breast cancer but also the functionality, tolerance, comorbidities, and life expectancy of patients to determine the best treatment...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005775/the-evolving-role-of-postmastectomy-radiation-therapy
#8
REVIEW
Ashlyn S Everett, Jennifer F De Los Santos, Drexell Hunter Boggs
Throughout various eras of breast cancer therapy, postmastectomy radiation therapy (PMRT) has played an important role in the treatment of locally advanced breast cancer. PMRT decreases locoregional recurrence and may improve overall survival in patients with tumors over 5 cm or positive lymph nodes. As novel cancer therapies improve survival in breast cancer, the role of radiation therapy is evolving. Individualized recommendations for PMRT dependent on pathologic response after neoadjuvant systemic therapy are under investigation...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005774/inflammatory-breast-cancer-what-to-know-about-this-unique-aggressive-breast-cancer
#9
REVIEW
Arjun Menta, Tamer M Fouad, Anthony Lucci, Huong Le-Petross, Michael C Stauder, Wendy A Woodward, Naoto T Ueno, Bora Lim
Inflammatory breast cancer (IBC) is a rare form of breast cancer that accounts for only 2% to 4% of all breast cancer cases. Despite its low incidence, IBC contributes to 7% to 10% of breast cancer caused mortality. Despite ongoing international efforts to formulate better diagnosis, treatment, and research, the survival of patients with IBC has not been significantly improved, and there are no therapeutic agents that specifically target IBC to date. The authors present a comprehensive overview that aims to assess the present and new management strategies of IBC...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005773/future-developments-in-neoadjuvant-therapy-for-triple-negative-breast-cancer
#10
REVIEW
Lakisha Moore-Smith, Andres Forero-Torres, Erica Stringer-Reasor
Breast cancer is the 2nd leading cause of cancer-related death in women in the United States. In general, advances in targeted treatment for breast cancer have improved over the last twenty years, except in the triple-negative breast cancer (TNBC) subtype. TNBC is an aggressive breast cancer subtype with limited treatment options as compared to hormone positive breast cancers. Recently, genomic profiling of TNBC shows promise in aiding clinicians to develop personalized targeted agents. Prioritizing novel molecular-based therapies in the neoadjuvant setting may help investigators understand mechanisms of resistance and ultimately improve patient outcomes in TNBC...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005772/definition-and-management-of-positive-margins-for-invasive-breast-cancer
#11
REVIEW
Apoorve Nayyar, Kristalyn K Gallagher, Kandace P McGuire
Breast-conserving surgery (BCS) followed by radiation therapy is the current standard of care for early stage breast cancer. Successful BCS necessitates complete tumor resection with clear margins at the pathologic assessment of the specimen ("no ink on tumor"). The presence of positive margins warrants additional surgery to obtain negative final margins, which has significant physical, psychological, and financial implications for the patient. The challenge lies in developing accurate real-time intraoperative margin assessment techniques to minimize the presence of "ink on tumor" and the subsequent need for additional surgery...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005771/management-of-the-axilla-in-the-patient-with-breast-cancer
#12
REVIEW
Ko Un Park, Abigail Caudle
Evaluation of the axillary lymph nodes is critical in the management of breast cancer because it is a key predictor of survival outcome. Surgeons must not only be able to perform sentinel lymph node dissection with high accuracy but also understand the implications of the results. Management of clinically node-negative and node-positive cases can vary significantly, as described in this review. With emerging data, management of the axilla in breast cancer will continue to evolve.
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005770/ductal-carcinoma-in-situ
#13
REVIEW
FangMeng Fu, Richard C Gilmore, Lisa K Jacobs
Ductal carcinoma in situ has been stable in incidence for a decade and has an excellent prognosis. Breast conservation therapy is safe and effective for most patients. Adjuvant whole breast radiation therapy is recommended to reduce the risk of local recurrence. Accelerated partial breast irradiation is a promising alternative to decrease toxicity and improve cosmetic results. Adjuvant hormonal therapy can reduce local recurrence, but should be used cautiously. Future directions in management include developing predictive tools for guidance for use of adjuvant therapy and selecting low-risk patients with ductal carcinoma in situ in whom surgery may be safely omitted...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005769/impact-of-advancing-technology-on-diagnosis-and-treatment-of-breast-cancer
#14
REVIEW
Heather I Greenwood, Katerina Dodelzon, Janine T Katzen
New emerging breast imaging techniques have shown great promise in breast cancer screening, evaluation of extent of disease, and response to neoadjuvant therapy. Tomosynthesis, allows 3-dimensional imaging of the breast, and increases breast cancer detection. Fast abbreviated MRI has reduced time and costs associated with traditional breast MRI while maintaining cancer detection. Diffusion-weighted imaging is a functional MRI technique that does not require contrast and has shown potential in screening, lesion characterization and also evaluation of treatment response...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005768/incorporating-biologic-factors-into-the-american-joint-committee-on-cancer-breast-cancer-staging-system-review-of-the-supporting-evidence
#15
REVIEW
Anna Weiss, Tari A King, Kelly K Hunt, Elizabeth A Mittendorf
The American Joint Committee on Cancer staging system has evolved in response to improved imaging, refined surgical techniques, enhanced pathologic evaluation, and greater understanding of tumor biology. The 8th edition has introduced clinical and pathologic prognostic stages for breast cancer that incorporate biologic variables (grade, estrogen/progesterone receptor status, HER2 status, multigene panels) with TNM categories that define the anatomic stage. The prognostic staging system facilitates more refined stratification than the anatomic stage with respect to survival and is an important advance that maintains the clinical relevance of the staging system by taking into account tumor biology and current treatment algorithms...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005767/breast-cancer-genetics-and-indications-for-prophylactic-mastectomy
#16
REVIEW
Helen Krontiras, Meagan Farmer, Julie Whatley
As more genetic information becomes available to inform breast cancer treatment, screening, and risk-reduction approaches, clinicians must become more knowledgeable about possible genetic testing and prevention strategies, including outcomes, benefits, risks, and limitations. The aim of this article is to define and distinguish high- and moderate-risk breast cancer predisposition genes, summarize the clinical recommendations that may be considered based on the identification of pathogenic variants (mutations) in these genes, and indications for risk-reducing and contralateral prophylactic mastectomy...
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/30005766/screening-mammography-recommendations-and-controversies
#17
REVIEW
Meredith Witten, Catherine C Parker
Over the past several years, there have been numerous changes in the guidelines for screening mammography. Additionally, different societies have released guidelines with variance in the recommendations of age to initiate and frequency of imaging. The current recommendations as well as the importance of screening mammography for early detection and survival are discussed.
August 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754630/preface
#18
EDITORIAL
Ajita S Prabhu
No abstract text is available yet for this article.
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754629/foreword
#19
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754628/approach-to-the-patient-with-chronic-groin-pain
#20
REVIEW
Q Lina Hu, David C Chen
Chronic postoperative inguinal pain has become a primary outcome parameter after elective inguinal hernia repair with significant consequences affecting patient productivity, employment, and quality of life. A systematic and thorough preoperative evaluation is important to identify the etiologies and types of pain. Owing to the complex nature of chronic pain, a multimodal and multidisciplinary treatment approach is recommended. Patients with chronic pain refractory to conservative measures may be considered for surgical intervention...
June 2018: Surgical Clinics of North America
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