Skip to main content

Breast Cancer

  • Chapter
  • First Online:
Surgical Oncology Manual

Abstract

Breast cancer is responsible for 26 % of all cancers in females and 14 % of all cancer-related deaths in females. 1 in every 9 women is expected to develop breast cancer during her lifetime and 1 in 30 women will die of breast cancer.

The surgical management of breast cancer requires an understanding of the complete spectrum of breast pathology, both malignant and premalignant. Within this chapter, an overview of this continuum is presented: from high-risk pathologies, through pre-invasive disease, to invasive disease and its subtypes. Relevant trials are presented, as are options and considerations for breast reconstruction.

Dan Charleton, Jessica Maxwell and Amanda Roberts are the co-first authors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian cancer statistics 2014. Toronto, ON: Canadian Cancer Society; 2014.

    Google Scholar 

  2. American Joint Committee on Cancer. AJCC cancer staging manual. 7th ed. New York, NY: Springer; 2010.

    Book  Google Scholar 

  3. Hartmann LC, Sellers TA, Frost MH, et al. Benign breast disease and the risk of breast cancer. N Engl J Med. 2005;353:229–37.

    Article  CAS  PubMed  Google Scholar 

  4. Collins LC, Baer HJ, Tamimi RM, et al. Magnitude and laterality of breast cancer risk according to histologic type of atypical hyperplasia: results from the Nurses’ Health Study. Cancer. 2007;109:180–7.

    Article  PubMed  Google Scholar 

  5. Fisher ER, Land SR, Fisher B, et al. Pathologic findings from the National Surgical Adjuvant Breast and Bowel Project: twelve-year observations concerning lobular carcinoma in situ. Cancer. 2004;100:238–44.

    Article  PubMed  Google Scholar 

  6. Masannat YA, Bains SK, Pinder SE, et al. Challenges in the management of pleomorphic lobular carcinoma in situ of the breast. Breast. 2013;22(2):194–6.

    Article  PubMed  Google Scholar 

  7. Sydnor MK, Wilson JD, Hijaz TA, et al. Underestimation of the presence of breast carcinoma in papillary lesions initially diagnosed at core-needle biopsy. Radiology. 2007;242:58–62.

    Article  PubMed  Google Scholar 

  8. Foley NM, Racz JM, Al-Hilli A, et al. An International Multicenter Review of the Malignancy Rate of Excised Papillomatous Breast Lesions. Ann Surg Oncol.

    Google Scholar 

  9. James BA, Cranor ML, Rosen PP. Carcinoma of the breast arising in microglandular adenosis. Am J Clin Pathol. 1993;100:507–13.

    Article  CAS  PubMed  Google Scholar 

  10. Koenig C, Dadmanesh F, Bratthauer GL, et al. Carcinoma arising in microglandular adenosis: an immunohistochemical analysis of 20 intraepithelial and invasive neoplasms. Int J Surg Pathol. 2000;8:303–15.

    Article  PubMed  Google Scholar 

  11. Brenner RJ, Jackman RJ, Parker SH, et al. Percutaneous core needle biopsy of radial scars of the breast: when is excision necessary? Am J Roentgenol. 2002;179:1179–84.

    Article  Google Scholar 

  12. Peres A, Barranger E, Becette V, et al. Rates of upgrade to malignancy for 271 cases of flat epithelial atypia (FEA) diagnosed by breast core biopsy. Breast Cancer Res Treat. 2011.

    Google Scholar 

  13. Uzoaru I, Morgan BR, Liu ZG, et al. Flat epithelial atypia with and without atypical ductal hyperplasia: to re-excise or not. Results of a 5-year prospective study. Virchows Arch. 2012;461(4):419–23.

    Article  PubMed  Google Scholar 

  14. Becker AK, Gordon PB, Harrison DA, et al. Flat ductal intraepithelial neoplasia 1A diagnosed at stereotactic core needle biopsy: is excisional biopsy indicated? AJR Am J Roentgenol. 2013;200(3):682–8.

    Article  PubMed  Google Scholar 

  15. Eusebi V, Feudale E, Foschini MP, et al. Long-term follow-up of in situ carcinoma of the breast. Semin Diagn Pathol. 1994;11:223–35.

    CAS  PubMed  Google Scholar 

  16. Virnig BA, Tuttle TM, Shamliyan T, et al. Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes. J Natl Cancer Inst. 2010;102(3):170.

    Article  PubMed  Google Scholar 

  17. Collins LC, Tamimi RM, Baer HJ, et al. Outcome of patients with ductal carcinoma in situ untreated after diagnostic biopsy: results from the Nurses’ Health Study. Cancer. 2005;103:1778–84.

    Article  PubMed  Google Scholar 

  18. Sanders ME, Schuyler PA, Dupont WD, et al. The natural history of low-grade ductal carcinoma in situ of the breast in women treated by biopsy only revealed over 30 years of long-term follow-up. Cancer. 2005;103:2481–4.

    Article  PubMed  Google Scholar 

  19. Fisher ER, Anderson S, Redmond C, et al. Pathologic findings from the national surgical adjuvant breast project protocol B-06. 10-year pathologic and clinical prognostic discriminants. Cancer. 1993;71:2507–14.

    Article  CAS  PubMed  Google Scholar 

  20. Boland GP, Chan KC, Knox WF, et al. Value of the Van Nuys prognostic index in prediction of recurrence of ductal carcinoma in situ after breast-conserving surgery. Br J Surg. 2003;90:426–32.

    Article  CAS  PubMed  Google Scholar 

  21. Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol. 1998;16(2):441–52.

    CAS  PubMed  Google Scholar 

  22. Bijker N, Meijnen P, Peterse JL, et al. Breast-conserving treatment with or without radiotherapy in ductal carcinoma-in-situ: ten-year results of European Organisation for Research and Treatment of Cancer randomized phase III trial 10853--a study by the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group. J Clin Oncol. 2006;24(21):3381–7. Epub 2006 Jun 26.

    Article  PubMed  Google Scholar 

  23. Cuzick J, Sestak I, Pinder SE, et al. Effect of tamoxifen and radiotherapy in women with locally excised ductal carcinoma in situ: long-term results from the UK/ANZ DCIS trial. Lancet Oncol. 2011;12:21–9.

    Article  CAS  PubMed  Google Scholar 

  24. Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast. Am J Surg. 2003;186(4):337–43.

    Article  PubMed  Google Scholar 

  25. Hughes LL, Wang M, Page DL, et al. Local excision alone without irradiation for ductal carcinoma in situ of the breast: a trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 2009;27(32):5319–24.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Wong JS, Chen YH, Gadd MA, et al. Eight-year update of a prospective study of wide excision alone for small low- or intermediate-grade ductal carcinoma in situ (DCIS). Breast Cancer Res Treat. 2014;143(2):343–50.

    Article  PubMed  Google Scholar 

  27. Fisher B, Dignam J, Wolmark N, et al. Tamoxifen in treatment of intraductal breast cancer: national surgical adjuvant breast and bowel project B-24 randomised controlled trial. Lancet. 1999;353:1993–2000.

    Article  CAS  PubMed  Google Scholar 

  28. Kell MR, Morrow M. An adequate margin of excision in ductal carcinoma in situ. BMJ. 2005;331:789–90.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Wang SY, Chu H, Shamliyan T, Jalal H, et al. Network meta-analysis of margin threshold for women with ductal carcinoma in situ. J Natl Cancer Inst. 2012;104(7):507–16.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Fisher B, Land S, Mamounas E, et al. Prevention of invasive breast cancer in women with ductal carcinoma in situ: an update of the national surgical adjuvant breast and bowel project experience. Semin Oncol. 2001;28:400–18.

    Article  CAS  PubMed  Google Scholar 

  31. Resch A, Fellner C, Mock U, et al. Locally recurrent breast cancer: pulse dose rate brachytherapy for repeat irradiation following lumpectomy- a second chance to preserve the breast. Radiology. 2002;225:713–8.

    Article  PubMed  Google Scholar 

  32. Weaver DL, Ashikaga T, Krag DN, et al. Effect of occult metastases on survival in node-negative breast cancer. N Engl J Med. 2011;364:412–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Baseline Staging Tests in Primary Breast Cancer. Hamm C, Tey R, reviewers Cancer care Ontario: Toronto (ON): Cancer Care Ontario; 2011. Available at: https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13868

  34. Meric F, Mirza NQ, Vlastos G, et al. Positive surgical margins and ipsilateral breast tumor recurrence predict disease-specific survival after breast-conserving therapy. Cancer. 2003;97:926–33.

    Article  PubMed  Google Scholar 

  35. Hanley C, Kessaram R. Quality of diagnosis and surgical management of breast lesions in a community hospital: room for improvement? Can J Surg. 2006;49:185–92.

    PubMed  PubMed Central  Google Scholar 

  36. Warner E. Systematic review: using magnetic resonance imaging to screen for women at high risk for breast cancer. Ann Intern Med. 2008;148(9):671–9.

    Article  PubMed  Google Scholar 

  37. Sardanelli F, Boetes C, Borish B. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer. 2010;46:1296–316.

    Article  PubMed  Google Scholar 

  38. Houssami N, Turner R, Morrow M. Preoperative magnetic resonance imaging in breast cancer: meta-analysis of surgical outcomes. Ann Surg. 2013;257(2):249–55.

    Article  PubMed  Google Scholar 

  39. Houssami N, Macaskill P, Marinovich ML. The association of surgical margins and local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy: a meta-analysis. Ann Surg Oncol. 2014;21(3):717–30.

    Article  PubMed  Google Scholar 

  40. Moran MS, Schnitt SJ, Giuliano AE, et al. Society of surgical oncology-american society for radiation oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. Ann Surg Oncol. 2014;21(3):704–16.

    Article  PubMed  Google Scholar 

  41. Buchholz TA, Somerfield MR, Griggs JJ, et al. Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol. 2014;32(14):1502–6.

    Article  PubMed  Google Scholar 

  42. Steele RJ, Forrest AP, Gibson T, et al. The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: a controlled randomized trial. Br J Surg. 1985;72:368–9.

    Article  CAS  PubMed  Google Scholar 

  43. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer—a multicenter validation study. N Engl J Med. 1998;339:941–6.

    Article  CAS  PubMed  Google Scholar 

  44. Lyman GH, Giuliano AE, Somerfield MR, et al. American society of clinical oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.

    Article  PubMed  Google Scholar 

  45. Mansel RE, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98:599–609.

    Article  PubMed  Google Scholar 

  46. Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 2010;11(10):927–33.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Fisher B, Montague E, Redmond C, et al. Findings from NSABP Protocol No. B-04-comparison of radical mastectomy with alternative treatments for primary breast cancer. I. Radiation compliance and its relation to treatment outcome. Cancer. 1980;46:1–13.

    Article  CAS  PubMed  Google Scholar 

  48. Galimberti V, Cole BF, Zurrida S, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14(4):297–305.

    Google Scholar 

  49. Newman LA, Mamounas EP. Review of breast cancer clinical trials conducted by the National Surgical Adjuvant Breast Project. Surg Clin North Am. 2007;87:279–305. vii.

    Article  PubMed  Google Scholar 

  50. Giuliano AE, McCall L, Beitsch P, et al. Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg. 2010;252:426–32.

    PubMed  Google Scholar 

  51. Orr RK. The impact of prophylactic axillary node dissection on breast cancer survival-a Bayesian meta-analysis. Ann Surg Oncol. 1999;6:109–16.

    Article  CAS  PubMed  Google Scholar 

  52. Joslyn SA. Hormone receptors in breast cancer: racial differences in distribution and survival. Breast Cancer Res Treat. 2002;73:45–59.

    Article  CAS  PubMed  Google Scholar 

  53. Truong PT, Bernstein V, Wai E, et al. Age-related variations in the use of axillary dissection: a survival analysis of 8038 women with T1-ST2 breast cancer. Int J Radiat Oncol Biol Phys. 2002;54:794–803.

    Article  PubMed  Google Scholar 

  54. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106.

    Article  CAS  PubMed  Google Scholar 

  55. Fisher B, Bauer M, Margolese R, et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985;312:665–73.

    Article  CAS  PubMed  Google Scholar 

  56. Cabanes PA, Salmon RJ, Vilcoq JR, et al. Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer. The Breast Carcinoma Collaborative Group of the Institut Curie. Lancet. 1992;339:1245–8.

    Article  CAS  PubMed  Google Scholar 

  57. Sanghani M, Balk EM, Cady B. Impact of axillary lymph node dissection on breast cancer outcome in clinically node negative patients: a systematic review and meta-analysis. Cancer. 2009;115:1613–20.

    Article  PubMed  Google Scholar 

  58. Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981–22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014;15:1303–10.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Whelan TJ, Olivotto IA, Parulekar WR, et al. Regional nodal irradiation in early-stage breast cancer. N Engl J Med 2015;373:307–16.

    Google Scholar 

  60. Pilewskie ML, Morrow M. Management of the clinically node-negative axilla: what have we learned from the clinical trials? Oncology (Williston Park). 2014;28(5):371–8.

    Google Scholar 

  61. Dixon JJ. A companion to specialist surgical practice breast surgery. Philadelphia: Saunders Elsevier; 2009.

    Google Scholar 

  62. Chia S, Swain SM, Byrd DR, et al. Locally advanced and inflammatory breast cancer. J Clin Oncol. 2008;26:786–90.

    Article  PubMed  Google Scholar 

  63. Kaufmann M, von Minckwitz MG, Bear HD, et al. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006. Ann Oncol. 2007;18:1927–34.

    Article  CAS  PubMed  Google Scholar 

  64. Colleoni M, Viale G, Zahrieh D, et al. Expression of ER, PgR, HER1, HER2, and response: a study of preoperative chemotherapy. Ann Oncol. 2008;19:465–72.

    Article  CAS  PubMed  Google Scholar 

  65. Rody A, Karn T, Solbach C, et al. The erbB2+ cluster of the intrinsic gene set predicts tumor response of breast cancer patients receiving neoadjuvant chemotherapy with docetaxel, doxorubicin and cyclophosphamide within the GEPARTRIO trial. Breast. 2007;16:235–40.

    Article  CAS  PubMed  Google Scholar 

  66. Braud AC, Asselain B, Scholl S, et al. Neoadjuvant chemotherapy in young breast cancer patients: correlation between response and relapse? Eur J Cancer. 1999;35:392–7.

    Article  CAS  PubMed  Google Scholar 

  67. van der Hage JA, van de Velde CJ, Julien JP, et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001;19:4224–37.

    PubMed  Google Scholar 

  68. Wolmark N, Wang J, Mamounas E, et al. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr. 2001;96–102.

    Google Scholar 

  69. Sabel MS. Sentinel lymph node biopsy before or after neoadjuvant chemotherapy: pros and cons. Surg Oncol Clin N Am. 2010;19:519–38.

    Article  PubMed  Google Scholar 

  70. Tan VK, Goh BK, Fook-Chong S, et al. The feasibility and accuracy of sentinel lymph node biopsy in clinically node-negative patients after neoadjuvant chemotherapy for breast cancer—a systematic review and meta-analysis. J Surg Oncol. 2011;104:97–103.

    Article  PubMed  Google Scholar 

  71. Boughey JC, Suman VJ, Mittendorf EA, Ahrendt GM, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer. The ACOSOG Z1071 (Alliance) Clinical Trial. JAMA. 2013;310(14):1455–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Boileau JF, Poirier B, Basik M, Holloway C, et al. Sentinel node biopsy following neoadjuvant chemotherapy in biopsy proven node positive breast cancer: The SN FNAC study. J Clin Oncol. 2015;33(3):258–64.

    Article  PubMed  Google Scholar 

  73. Fisher CS, Ma CX, Gillanders WE, et al. Neoadjuvant chemotherapy is associated with improved survival compared with adjuvant chemotherapy in patients with triple-negative breast cancer only after complete pathologic response. Ann Surg Oncol. 2012;19:253–8.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Bell C. A system of operative surgery. Hale & Homer, 1814.

    Google Scholar 

  75. Li BD, Sicard MA, Ampil F, et al. Trimodal therapy for inflammatory breast cancer: a surgeon’s perspective. Oncology. 2010;79:3–12.

    Article  PubMed  Google Scholar 

  76. Robertson FM, Bondy M, Yang W, et al. Inflammatory breast cancer: the disease, the biology, the treatment. CA Cancer J Clin. 2010;60:351–75.

    Article  PubMed  Google Scholar 

  77. Rosenkranz KM, Lucci A. Surgical treatment of pregnancy associated breast cancer. Breast Dis. 2005;23:87–93.

    PubMed  Google Scholar 

  78. Amant F, Deckers S, Van CK, et al. Breast cancer in pregnancy: recommendations of an international consensus meeting. Eur J Cancer. 2010;46:3158–68.

    Article  PubMed  Google Scholar 

  79. Veronesi U, Zucali R, Luini A. Local control and survival in early breast cancer: the Milan trial. Int J Radiat Oncol Biol Phys. 1986;12:717–20.

    Article  CAS  PubMed  Google Scholar 

  80. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Version 3.2014. 04/01/2014. Available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site. Accessed 23 Oct 2014.

  81. Mondi MM, Cuenca RE, Ollila DW, et al. Sentinel lymph node biopsy during pregnancy: initial clinical experience. Ann Surg Oncol. 2007;14:218–21.

    Article  PubMed  Google Scholar 

  82. Johnson MT, Guidroz JA, Smith BJ, et al. A single institutional experience of factors affecting successful identification of sentinel lymph node in breast cancer patients. Surgery. 2009;146:671–6.

    Article  PubMed  Google Scholar 

  83. Khera SY, Kiluk JV, Hasson DM, et al. Pregnancy-associated breast cancer patients can safely undergo lymphatic mapping. Breast J. 2008;14:250–4.

    Article  PubMed  Google Scholar 

  84. Pockaj BA, Wasif N, Dueck AC, et al. Metastasectomy and surgical resection of the primary tumor in patients with stage IV breast cancer: time for a second look? Ann Surg Oncol. 2010;17:2419–26.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Khan SA, Stewart AK, Morrow M. Does aggressive local therapy improve survival in metastatic breast cancer? Surgery. 2002;132:620–6.

    Article  PubMed  Google Scholar 

  86. Beslija S, Bonneterre J, Burstein HJ, et al. Third consensus on medical treatment of metastatic breast cancer. Ann Oncol. 2009;20:1771–85.

    Article  CAS  PubMed  Google Scholar 

  87. Fields RC, Jeffe DB, Trinkaus K, et al. Surgical resection of the primary tumor is associated with increased long-term survival in patients with stage IV breast cancer after controlling for site of metastasis. Ann Surg Oncol. 2007;14:3345–51.

    Article  PubMed  Google Scholar 

  88. Babiera GV, Rao R, Feng L, et al. Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol. 2006;13:776–82.

    Article  PubMed  Google Scholar 

  89. Blanchard DK, Shetty PB, Hilsenbeck SG, et al. Association of surgery with improved survival in stage IV breast cancer patients. Ann Surg. 2008;247:732–8.

    Article  PubMed  Google Scholar 

  90. Neuman HB, Morrogh M, Gonen M, et al. Stage IV breast cancer in the era of targeted therapy: does surgery of the primary tumor matter? Cancer. 2010;116:1226–33.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Bafford AC, Burstein HJ, Barkley CR, et al. Breast surgery in stage IV breast cancer: impact of staging and patient selection on overall survival. Breast Cancer Res Treat. 2009;115:7–12.

    Article  PubMed  Google Scholar 

  92. Hazard HW, Gorla SR, Scholtens D, et al. Surgical resection of the primary tumor, chest wall control, and survival in women with metastatic breast cancer. Cancer. 2008;113:2011–9.

    Article  PubMed  Google Scholar 

  93. Ly BH, Vlastos G, Rapiti E, et al. Local-regional radiotherapy and surgery is associated with a significant survival advantage in metastatic breast cancer patients. Tumori. 2010;96:947–54.

    PubMed  Google Scholar 

  94. Gnerlich J, Jeffe DB, Deshpande AD, et al. Surgical removal of the primary tumor increases overall survival in patients with metastatic breast cancer: analysis of the 1988-2003 SEER data. Ann Surg Oncol. 2007;14:2187–94.

    Article  PubMed  Google Scholar 

  95. Rao R, Feng L, Kuerer HM, et al. Timing of surgical intervention for the intact primary in stage IV breast cancer patients. Ann Surg Oncol. 2008;15:1696–702.

    Article  PubMed  Google Scholar 

  96. Cady B, Nathan NR, Michaelson JS, et al. Matched pair analyses of stage IV breast cancer with or without resection of primary breast site. Ann Surg Oncol. 2008;15:3384–95.

    Article  CAS  PubMed  Google Scholar 

  97. Badwe RA. A randomized trial to assess the impact of locoregional treatment on survival of patients with metastatic breast cancer at first presentation. Available from: http://clinicaltrials.gov/show/NCT00193778. Updated 2013. Presented at SABCS 2013. Accessed 27 Oct 2014.

  98. Soran A. The effect of primary surgical treatment on survival in patients with metastatic breast cancer at diagnosis. http://clinicaltrials.gov/show/NCT00557986. Updated 2012. Presented at SABCS 2013. Accessed 27 Oct 2014.

  99. Khan SA. A randomized phase III trial of the value of early local therapy for the intact primary tumor in patients with metastatic breast cancer. Available from: http://clinicaltrials.gov/show/NCT01242800. Updated 2014. Accessed 27 Oct 2014.

  100. Piyapant A. Role of surgery for the primary in patients with breast cancer stage IV: a prospective randomized multicenter controlled trial. Available from: http://clinicaltrials.gov/show/NCT01906112. Updated 2014. Accessed 27 Oct 2014.

  101. Easson AM, McCready DR. Management of local recurrence of breast cancer. Expert Rev Anticancer Ther. 2004;4:219–26.

    Article  PubMed  Google Scholar 

  102. Cabioglu N, Hunt KK, Buchholz TA, et al. Improving local control with breast-conserving therapy: a 27-year single-institution experience. Cancer. 2005;104:20–9.

    Article  PubMed  Google Scholar 

  103. Recht A, Pierce SM, Abner A, et al. Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinoma. J Clin Oncol. 1991;9:988–96.

    CAS  PubMed  Google Scholar 

  104. Willner J, Kiricuta IC, Kolbl O. Locoregional recurrence of breast cancer following mastectomy: always a fatal event? Results of univariate and multivariate analysis. Int J Radiat Oncol Biol Phys. 1997;37:853–63.

    Article  CAS  PubMed  Google Scholar 

  105. Albornoz CR, Bach PB, Mehrara BJ, et al. A paradigm shift in US breast reconstruction: increasing implant rates. Plast Reconstr Surg. 2013;131:15–23.

    Article  CAS  PubMed  Google Scholar 

  106. Stevens LS, McGrath MH, Druss RG, Gump FE, Forde KA. The psychological impact of immediate reconstruction for women with early breast cancer. Plast Reconstr Surg. 1984;73:619–28.

    Article  CAS  PubMed  Google Scholar 

  107. Schain WS. Breast Reconstruction. Update of psychosocial and pragmatic concerns. Cancer. 1991;68:1170–5.

    Article  CAS  PubMed  Google Scholar 

  108. Downes KJ, Glatt BS, Kanchwala SK, et al. Skin sparing mastectomy and immediate reconstruction is an acceptable treatment option for patients with high risk breast carcinoma. Cancer. 2005;103:906–13.

    Article  PubMed  Google Scholar 

  109. Chevray PM. Timing of Breast Reconstruction: Immediate versus Delayed. Cancer J. 2008;14(4):223–9.

    Article  PubMed  Google Scholar 

  110. Lantis S, Tekkis PP, Sgourakis G, et al. Comparison of skin-sparing mastectomy versus non-skin-sparing mastectomy for breast cancer: A meta-analysis of observational studies. Ann Surg. 2010;251:632–9.

    Article  Google Scholar 

  111. Wijayanayagam A, Kumar AS, Rd F, et al. Optimaizing the total skin-sparing mastectomy. Arch Surg. 2008;143:38–45.

    Article  PubMed  Google Scholar 

  112. Yao K, Liederback E, Tang R, et al. Nipple-sparing mastectomy in BRCA ½ mutation carriers: An interim analysis and review of the literature. Ann Surg Oncol. 2015;22(2):370–6.

    Article  PubMed  Google Scholar 

  113. Shea-Budgell M, Quan ML, Mehling B, et al. Breasy reconstruction following prophylactic or therapeutic mastectomy for breast cancer: Recommendations from an evidence-based provincial guideline. Plast Surg. 2014;22(2):103–11.

    Google Scholar 

  114. Man LX, Selber JC, Serlettu JM. Abdominal wall following free TRAM or DIEP reconstruction: A meta-analysis and critical review. Plast Reconstr Surg. 2009;124:752–64.

    Article  CAS  PubMed  Google Scholar 

  115. Egeberg A, Rasmussen MK, Ahm SJ. Comparing the donor site morbidity using the DIEP, SIEA, or MS-TRAM flaps for breast reconstructive surgery : A meta-analysis. J Plast Reconstr Aesthet Surg. 2012;65:1474–80.

    Article  PubMed  Google Scholar 

  116. Futter CM, Weiler-Mithoff E, Hagen S, et al. Do pre-operative abdominal site exercises prevent post-operative donor site complications for women undergoing DIEP flap breast reconstruction? A two-centre, prospective randomised control trial. Br J Plast Surg. 2003;56:674–83.

    Article  CAS  PubMed  Google Scholar 

  117. Zakireh J, Fowble B, Esserman LJ. Application of screening principles to the reconstructed breast. J Clin Oncol. 2010;28:173–80.

    Article  Google Scholar 

  118. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.

    Article  PubMed  Google Scholar 

  119. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dan Charleton M.D., F.R.C.S.C. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 University of Toronto General Surgery Oncology Program

About this chapter

Cite this chapter

Charleton, D. et al. (2016). Breast Cancer. In: Wright, F., Escallon, J., Cukier, M., Tsang, M., Hameed, U. (eds) Surgical Oncology Manual. Springer, Cham. https://doi.org/10.1007/978-3-319-26276-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26276-5_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26274-1

  • Online ISBN: 978-3-319-26276-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics