CONTENTS

SectionEditors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii

Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv

Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv

Preface.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XXVII

Acknowledgments.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxix

MultidisciplinaryTrainingfor BreastSurgicalOncology xxxi

TheInfluenceof the News Media and the Internet onBreastCancerPatient Careand Research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xliii

ETIOLOGY,ASSESSINGRISK,INITIALEVALUATION,ANO MANAGEMENT

ThomasB.Julian,DavidEuhus,Irenelo Wapnir

1.BreastCarcinogenesis 3paull. vanDiest,HorstBuerger,AmoKuijper,Elskenvander Wall

2.Invasion. . . . . . . . . . . . . . . . . . . . . . . .. 17

ChristopherB.Umbricht

3.Metastasis. . . . . . . . . . . . . . . . . . . . . .. 27AlisonL.Allan

4.Epidemiologyof BreastCancer. . . . . .. 41DezhengHuo,lamesDignam

5.BreastCancerScreening.. . . . . . . . . . .. 51HaydeeOjeda-Foumier,ChristopherE.Comstock

6.Componentsof a BreastCareprogram. . . . . . . . . . . . . . . . . . . . . . . .. 61E.ShelleyHwang,Laurol. Esserman

7.Establishinga CancerGeneticsService. . . . . . . . . . . . . . . . . . . . . . . . .. 73

Deborohj. MacDonald

8.GeneticPredispositionSyndromes.. . .. 81LindaRobinson

9.QuantitativeRiskPrediction.. . . . . . . .. 89DavidEuhus

10.Chemopreventionin the ClinicalSetting. . . . . . . . . . . . . . . . . . . . . . . . . . 97AtillaSoron,VictorG.Vogel

11. Prophylactic Mastectomy . . . . . . . . . .. 111ludy C.Boughey,AmyC.Degnim

12.History,PhysicalExamination,andStaging 119ChristineLaronga,SharonTollin,KironTuroga

13.Initial AJCCStaging. . . . . . . . . . . . . . .. 135C.DeniseChing,StephenB.Edge,SavitriKrishnamurthy,S.EvaSingletary

14.Communicatinga BreastCancerDiagnosis. . . . . . . . . . . . . . . .. 147WalterBaile, LauroDominici

PATHOLOGYOFTHEBREASTANO ClINICALMANAGEMENT

SavitriKrishnamurthy,RacheM. Simmons

15.BreastSpecimenTissueProcessing. .. 155EdiBrogi,Vio/ettoBorboshino

16.BenignConditionsof the Breast . . . .. 165Miehoe/P.Osbome,SusonK.Boo/bo/,juhi Asod

17.High-RiskLesions:ALH/LCIS/ADH. . .. 179Chone/E.Smort,ColinM.Fumivo/,SunilR.Lokhoni

18.DuctalCarcinomaIn Situ . . . . . . . . . .. 189Me/vinJ.Si/verstein,Miehoe/D.Logios

19.PagetDiseaseof the Breast.. . . . . . .. 209NimmiAroro,RoeheM.Simmons

20.lnvasiveBreastCarcinoma.. . . . . . . .. 215DovidR.MeCreody,NoomiA.Mil/er,Brueej. Youngson

21.MaleBreastCancer. . . . . . . . . . . . . .. 237Mohmoud E/-Tomer,Benjomin Pocoek

22.Prognosticand PredictiveFactorsinBreastCancer. . . . . . . . . . . . . . . . . . .. 243CelinoG.K/eer,Miehoe/S.Sobe/

23.Nonepithelial Neoplasmsof theBreast.. . . . . . . . . . . . . . . . . . . . . . . .. 251

TinoW.F.Yen,jennifer D.Lorek,ZoinobBosir

24.Cytologyin BreastCareManagement. . . . . . . . . . . . . . . . . . .. 269SovitriKrishnomurthy

25.PathologyPost-NeoadjuvantTherapy. . . . . . . . . . . . . . . . . . . . . . .. 277W.FroserSymmons

26.Axillary and SentinelLymph NodeEvaluation.. . . . . . . . . . . . . . . . . . . . .. 289

RoderiekR.Tumer,He/enMobry,ArmondoE.Giu/iono

27. MinimalResidualCancer. . . . . . . . . .. 297StephonBroun,BjomNoume,E/inBorgen

IMAGING

PatW.Whitworth,Terri-AnnGizienski

28.Mammography.. . . . . . . . . . . . . . . . .. 309Ion Grady,Pot Honsen

29.StereotacticBreastBiopsy. . . . . . . . .. 335RondStock,ArthurLemer

30.Anatomy and Ultrasoundof the BreastandAtlasof UltrasoundFindings. . . .. 343joy K.Homess

31A.BasicBreastUltrasound,Certification,and Accreditationfor the Surgeon.. . . 365HowordSnider

31B.Screening Breast Ultrasound . . . . . . .. 379EdgorD.Storen

32.Selectionof UltrasoundMachineandOfficeSetup. . . . . . . . . . . . . . . . . . . .. 383ErieB. Whitocre

33. Image-GuidedPercutaneousBreastBiopsy.. . . . . . . . . . . . . . . . . .. 391PotW.Whitworth

34. UltrasoundEvaluationof the LymphaticSpreadof BreastCancer.. . . . . . . . . . . 403BrunoD.Fomoge

35. BreastMagneticResonanceImaging... 409E/izobethMorris,ElisoPort

36.SystemicStagingand the RadiologicWork-Up of Abnormal Findings . . . . .. 429TonyoW.Stephens,E/eniAndreopou/ou

lANDMARKClINICAl TRIAlS INBREASTSURGICAlONCOlOGY

EleftheriosP.Mamounas

37.StatistiealDesignand Analysisofphase 111Clinieal Trials . . . . . . . . . . . .. 441josephP.Costantino,StewartAnderson,GregYothers

38.StudyConduet. . . . . . . . . . . . . . . . . .. 451WalterM. Cronin

39.ProtoeolComponentsandproduetion. . . . . . . . . . . . . . . . . . . . .. 455AliceMatura,AuroroMadrigal

40.TissueAequisitionand BankingfarBreastCaneer. . . . . . . . . . . . . . . . . . .. 461

SoonmyungPaik

41.Fundingfor ClinicalTríals. . . . . . . . . .. 469EdwardL. Trimble,AndreaDenicoff,jeffrey Abrams

42.TheNSABPExperienee.. . . . . . . . . . .. 475EleftheriosP.Mamounas,D.LawrenceWickerham,BernardFisher,CharlesE.Geyer,ThomasB.julian, NormanWolmark

43.TheMilan CaneerInstitute's landmarkCliniealTrials.. . . . . . . . . . . . . . . . . . .. 509UmbertoVeronesi,StefanoZurrida

44.TheACOSOGExperienee.. . . . . . . . . .. 517judy C.Boughey,Kelly K. Hunt

45.TheEORTCExperienee:FromDClStoloeally AdvaneedBreastCaneer.. . . .. 531HarryBartelink,PhilipMeijnen,MariekeStraver,EmielRutgers

46.TheUKExperienee. . . . . . . . . . . . . . .. 539jayant S.Vaidya

47.TheAustrianBreastand ColoreetalCaneerStudyGroupExperienee. . . . .. 561SebastianF.Schoppmann,KarlThomanek,MichaelGnant,Raimundjakesz

48.TheGermanExperienee:PrimarySystemicTherapywith CytotoxicAgents. . . . . . . . . . . . . . . . . . . . . . . .. 569MichaelUntch,GuntervonMinckwitz

49.TheEasternCooperativeOncologyGroup(ECOG)Experienee.. . . . . . . . .. 575Lawrencej. Solin

50.TheCaneerand leukemia GroupBTrials.. . . . . . . . . . . . . . . . . . . . . . . . .. 583

AmandaJ. Wheeler,Barbara L.Smith,Kevin Hughes

51.TheRTOGExperienee. . . . . . . . . . . . .. 591Beryl McCormick,julio White

OPERATIVEMANAGEMENT

Anthonylucci,TariKing

52.ParavertebralBloekas an AnestheticTeehniquein PatientsUndergoingBreastCaneerSurgery. . . . . . . . . . . .. 597FarzinGoravanchi,RonaldParris

53.ExcisionalBreastBiopsy. . . . . . . . . . .. 603LeslieMontgomery

54.TissueMarkingand Proeessing.. . . .. 609AmandaL.Kong,AlexandraShayeBrown

55.Needle loealization and RadioguidedOeeultlesion loealization Teehniques 613SimonettaMonti,julio Rodriguez-Fernandez,HelioRubensDeOliveiraFilho

56.Mammographicand IntraoperativeUltrasoundGuidance. . . . . . . . . . . . . . 619RichardE.Fine

57.CentralDuctExplorationtor NippleDischarge. . . . . . . . . . . . . . . . . . . . . .. 631LisaM.ScJafani

58.Endoscopytor NippleDischarge.. . . .. 637julianKim

59.IntraductalTherapy. . . . . . . . . . . . . .. 643Robertj. Goulet,jr, TheodoreN. Tsangaris,SusanM. Love

60.Cryoablationot Fibroadenomas. . . . .. 647Pat W.Whitworth,JaimeLewis

61.Breast-ConservingSurgery.. . . . . . . .. 653Mary Morrogh, Viltorio lanini, LeaRegolo,Beltina Ballardini, Lisa Wiechmann,VirgilioSacchini

62.SentinelLymphNodeBiopsy.. . . . . .. 669jennifer R.Garreau,ArmandoE.Giuliano

63.Axillary LymphNode Dissection.. . . .. 679HeatherB.Neuman,Kimber/yJ. Vanlee

64.Moditied RadicalMastectomyandTechniquestor Avoiding SkinNecrosis. . . . . . . . . . . . . . . . . . . . . . .. 693

RoshniRao,A. Marilyn Leitch

65.TheConceptot ProphylacticMastectomy. . . . . . . . . . . . . . . . . . . . . 699/sabelleBedrosian

66.Skin-SparingMastectomy.. . . . . . . . .. 705judy C.Boughey,KariM. Rosenkranz

67.Nipple- and Areola-SparingMastectomy . . . . . . . . . . . . . . . . . . . .. 711MeredithKato,RacheM.Simmons

68.Radicaland ExtendedRadicalMastectomy. . . . . . . . . . . . . . . . . . . .. 719ReginaM. Fearmonti,ElisabethK.Beahm

69.Managementot LocalRecurrenceatterMastectomy.. . . . . . . . . . . . . . .. 731AneesB.Chagpar

70.Surgerytor Gynecomastia. . . . . . . . .. 737SarahMcLaughlin,HiramS.Cody

71.CentralVenousAccessin BreastOncologypatients . . . .. 745AprilSpencer,ErvinB.Brown

72.Surgeryin Patientswith StageIVMetastaticBreastCancer. . . . . . . . . . . 753jane E.Méndez,S.EvaSingletary,GildyV.Babiera

PLASTICANO BREASTRECONSTRUCTION

StevenJ.Kronowitz

73.TheEpidemiologyot BreastReconstructionin North America . . . . . . . . . . . . . . . .. 761

AmyK.Alderman,RachelStreu,EdwinG.Wilkins

74.OncologicConsiderationstor BreastReconstruction. . . . . . . . . . . . . . . . . .. 771GrantW.Car/son

75.Considerationsand Strategiestor theTiming ot BreastReconstruction 779StevenJ.Kronowitz

76.Partial BreastReconstructionUsingLocalTissue. . . . . . . . . . . . . . . . . . . .. 791AlbertLosken

77.lmmediate Repairot PartialMastectomyDetectsUsingpertorator Flaps.. . . . .. 803MoustaphaHamdi,FilipStillaert

78.Correctionot PartialBreastDetormitieswith the LipomodelingTechnique. . . . 815EmmanuelDelay

79. Implant-BasedReconstruction. . . . . .. 827Peter Cordeiro,ColleenMcCarthy

80.BreastReconstructionwith theAutogenouslatissimusFlap.. . . . . . .. 835BarbaraPersons,BethCollins,ChristophPapp,john MeCraw

Contents

81.Total BreastReconstructionUsingAutologousTissue:TRAM,OIEP,and SIEA Flaps . . . . . . . . . . . . . . . . . .. 845Mauriee Y.Nahabedian,Ketan Patel

SYSTEMICTHERAPYOFBREASTCANCER

lisa Carey,DavidW.Ollila

82.GeneralNCCNGuidelines. . . . . . . . . .. 857P.K.Morrow,RiehardTheriault

83.Selectionof Patientsfor Therapy.. . .. 867WilliamIrvin,jr, KeithAmos

84.NeoadjuvantEndocrineTherapy . . . .. 877E.jane Macaskill,j. MiehaelDixon

85.NeoadjuvantChemotherapy. . . . . . .. 885FundaMeric-Bernstam

86.EndocrineTherapy. . . . . . . . . . . . . . .. 895prudeneeA.Francis

87.Adjuvant Chemotherapy . . . . . . . . . .. 905SaraM. Tolaney,Ion E.Krop

88.BiologicTherapy.. . . . . . . . . . . . . . . .. 913janet K.Horton,E.ClaireDees,NaneyKlauber-DeMore

89. pregnancyand BreastCancer .. 921DavidW.Ollila,SusanMeKenney

90.InflammatoryBreastCancer.. . . . . . .. 927VivianaNegrónGonzólez,julio L.Oh,MassimoCristofanilli,GildyV.Babiera

91. BreastCancerVaccines.. . . . . . . . . . .. 937ElizabethA. Mittendorf,Brianj. Czernieeki,GeorgeE.Peoples

92.MetastaticBreastCancer. . . . . . . . . .. 947HopeS.Rugo

RADIATlON

Bruce G. Haffty

93.ConceptualBasisand PrincipiesofRadiationOncology. . . . . . . . . . . . . .. 957BrueeG.Haffty,VenkatNarra,NingJ.Yue

94.Whole-BreastRadiationFollowingBreast-ConservingTherapyforNoninvasiveand InvasiveCancers.. .. 969MeenaS.Moran

95.AcceleratedPartialBreastIrradiation.. . . . . . . . . . . . . . . . . . . . .. 981

SharadGoyal,VictorZannis

96.postmastectomyRadiationTherapy... 995Atif j. Khan,BrueeG.Haffty

97.RadiationTherapyin MetastaticOisease.. . . . . . . . . . . . . . . . . . . . . .. 1009

KathleenC.Horst

li Contents

FOLLOW-UPANO COMPUCATIONSFOLLOWINGDIAGNOSISANO THERAPY

Tara Breslin, Mehra Golshan

98. Guidelines for Follow-Up . . . . . . . . .. 1021Alicia Growney,jennifer j. Griggs

99.TumorRegistry.. . . . . . . . . . . . . . . .. 1027LukeM. Funk,CopriceC.Greenberg

100.Psyehosocial.. . . . . . . . . . . . . . . . . .. 1033Michelle8. Ribo,ProchiAgorw%

101.Fertility, Sexuality,and MenopausalSymptomManagement. . . . . . . . . .. 1041KathrynJ. Ruddy,Ann H. Partridge

102.Disparitiesin BreastCaneer. . . . . . .. 1051Nich%s Osborne,LisoNewmon

103.SurgicalComplicationsandManagement . . . . . . . . . . . . . . . . . .. 1059Kondicef. Ki/bride

104.Lymphedema.. . . . . . . . . . . . . . . . .. 10675teveNorton

105.Diet and Exercisein BreastCaneerSurvivorship. . . . . . . . . . . . . . . . . . .. 1081jennifer Ligibe/

'ndex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1089