Surgical management of early breast cancer

Raquel Prati, Kirby I. Bland, Vicki Klimberg

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The advent of screening mammography and its widespread application has resulted in more patients being diagnosed with small invasive breast cancers. Most of these early breast cancer patients can be treated with breast conservation surgery and sentinel lymphadenectomy followed by radiotherapy. Preoperative planning includes a tissue diagnosis of cancer before proceeding to surgery and assessment of whether the patient can receive radiotherapy. Surgical incisions used in breast conservation surgery should be placed such as to maximize cosmesis but not compromise a mastectomy, if one is needed. Surgeons should play an active role in inking the margins and assessing margin status intraoperatively. Shaved margins aid in obtaining negative margins. Sentinel lymphadenectomy for axillary evaluation has become the primary tool in axillary evaluation in patients with early breast cancers. Percutaneous ablation has been shown to adequately treat primary and metastatic disease in multiple organs, including the liver, kidneys, lungs, brain, and prostate. Questions regarding its applicability to breast cancer treatment have arisen over the past 2 decades. Although no large, randomized trials have been performed to assess the feasibility of replacing lumpectomy with percutaneous ablation in breast conserving therapy for early-stage breast cancer, a growing body of literature supports the safety and efficacy of percutaneous ablation and stresses the importance of undertaking such a trial.

Original languageEnglish (US)
Title of host publicationThe Breast
Subtitle of host publicationComprehensive Management of Benign and Malignant Diseases
PublisherElsevier Inc.
Pages643-662.e4
ISBN (Print)9780323359559
DOIs
StatePublished - Aug 24 2017

Keywords

  • Ablation
  • Breast conservation therapy
  • Cryoablation
  • Electroporation
  • HIFU
  • Laser
  • Lumpectomy
  • Oncoplastic
  • Radiation
  • Radiofrequency
  • Ultrasound

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Prati, R., Bland, K. I., & Klimberg, V. (2017). Surgical management of early breast cancer. In The Breast: Comprehensive Management of Benign and Malignant Diseases (pp. 643-662.e4). Elsevier Inc.. https://doi.org/10.1016/B978-0-323-35955-9.00045-3