Early-Stage Breast Cancer: New Developments and Controversies, An Issue of Surgical Oncology Clinics - E- Book

Eleftherios P. Mamounas

Description

This issue of the Surgical Oncology Clinics will focus on new advances in Breast Cancer Surgery, and will include articles on Chemoprevention, Breast MRI, Genomics, Sentinel Node Biopsy, Extra-axillary Sentinel Nodes, Skin-Sparing and Nipple Sparing Mastectomy, Oncoplastic Techniques, Neoadjuvant Hormonal Therapy, Neoadjuvant Chemotherapy, Adjuvant Hormonal Therapy, Adjuvant Chemotherapy, and Biologic Targeted Therapies.

Sujets

• Médecine
• Médecine Générale
• Medical
• Oncology

Informations

• Publié par: Saunders
• Date de parution: 30 juillet 2010
• Nombre de lectures: 0
• EAN13: 9781455700707
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Surgical Oncology Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1055-3207
doi: 10.1016/S1055-3207(10)00041-4

Contributors
Surgical Oncology Clinics of North America
Early-Stage Breast Cancer: New Developments and Controversies
Eleftherios P. Mamounas
Aultman Cancer Center, 2600 6th Street, SW Canton, OH 44710, USA
ISSN  1055-3207
Volume 19 • Number 3 • July 2010

Contents
Cover
Contributors
Forthcoming Issues
Foreword
Preface
Erratum
Breast Cancer Chemoprevention: Progress and Controversy
Magnetic Resonance Imaging for Screening, Diagnosis, and Eligibility for Breast-conserving Surgery: Promises and Pitfalls
Clinical Significance of Minimal Sentinel Node Involvement and Management Options
Clinical Significance and Management of Extra-Axillary Sentinel Lymph Nodes: Worthwhile or Irrelevant?
Sentinel Lymph Node Biopsy Before or After Neoadjuvant Chemotherapy: Pros and Cons
Sentinel Lymph Node Surgery in Uncommon Clinical Circumstances
Total Skin Sparing (Nipple Sparing) Mastectomy: What is the Evidence?
Oncoplastic Surgery: A Creative Approach to Breast Cancer Management
Clinical Application of Gene Expression Profiling in Breast Cancer
Neoadjuvant Chemotherapy for Operable Breast Cancer: Individualizing Locoregional and Systemic Therapy
Neoadjuvant Endocrine Therapy for Breast Cancer
Adjuvant Hormonal Therapy for Early-Stage Breast Cancer
Adjuvant Chemotherapy in Early-Stage Breast Cancer: What, When, and for Whom?
Targeted Therapies in Early-Stage Breast Cancer: Achievements and Promises
Index
Surgical Oncology Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1055-3207
doi: 10.1016/S1055-3207(10)00043-8

Forthcoming Issues
Surgical Oncology Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1055-3207
doi: 10.1016/j.soc.2010.04.008

Foreword

Nicholas J. Petrelli, MD
Helen F. Graham Cancer Center, 4701 Ogletown-Stanton Road, Suite 1213, Newark, DE 19713, USA
E-mail address: [e-mail]


Nicholas J. Petrelli, MD Consulting Editor
This issue of the Surgical Oncology Clinics of North America is devoted to breast cancer. The last edition of the Clinics on breast cancer was in 2005; hence, it is time for an update. The Guest Editor for this edition is Eleftherios Mamounas, MD, MPH, FACS, professor of surgery at Northeastern Ohio University College of Medicine in Rootstown, Ohio. Dr Mamounas is also medical director of the Aultman Cancer Center in Canton, Ohio, and chair of the Breast Committee of the National Surgical Adjuvant Breast and Bowel Project. He has held this latter position since 1997. Perhaps the best way to describe Dr Mamounas is by a direct quotation from the last National Surgical Adjuvant Breast and Bowel Project cooperative group National Cancer Institute site report, which described Dr Mamounas as a “strong, extremely knowledgeable and capable surgical oncologist…who does an impressive job with coordinating a very powerful cadre of other surgeons and medical oncologists that serve on this committee.”
This edition of the Surgical Oncology Clinics of North America contains 14 articles. It covers many areas, including the role of MRI for screening, diagnosis, and eligibility for breast-conserving surgery, as discussed by Dr Monica Morrow from Memorial Sloan-Kettering Cancer Center, to neoadjuvant chemotherapy for operable breast cancer by Dr Harry Bear from Virginia Commonwealth University. Additional areas discussed are sentinel node biopsy before or after neoadjuvant chemotherapy by Dr Michael Sabel from the University of Michigan and targeted therapies in early-stage breast cancer by Dr George Sledge and associates from Indiana University's Simon Cancer Center.
Dr Mamounas discusses in his preface the reasons that since the mid-1980s there has been a worldwide steady decline in breast cancer mortality that has persisted to date without any evidence of a slow down. According to the American Cancer Society, breast cancer rates have risen approximately 30% in the past 25 years in Western countries, the reason in part due to increased screening discovering the cancer in its earliest stages. In the United States, breast cancer rates decreased by 10% between 2000 and 2004 due in part to a reduction in the use of hormone replacement therapy. Although breast cancer rates are rising in many Western countries, deaths from the disease have decreased in many countries as a result of improved screening and treatment.
Dr Mamounas and his colleagues continue to research surrogate endpoint biomarkers to serve as early indicators of treatment effectiveness along with developing better breast imaging and other technologies for the diagnosis of breast cancer. Together with research in the academic centers and the National Cancer Institute cooperative groups clinical trials process, we will continue to advance in the prevention, early diagnosis, and treatment of breast cancer.
I would like to thank Dr Mamounas and his colleagues for this edition of the Surgical Oncology Clinics of North America , which can serve as a practical resource for physicians and individuals in training.
Surgical Oncology Clinics of North America , Vol. 19, No. 3, July 2010
ISSN: 1055-3207
doi: 10.1016/j.soc.2010.04.007

Preface

Eleftherios P. Mamounas, MD, MPH
Aultman Cancer Center, 2600 6th Street, SW, Canton, OH 44710, USA
Northeastern Ohio Universities College of Medicine, Rootstown, OH, USA
E-mail address: [e-mail]


Eleftherios P. Mamounas, MD, MPH Guest Editor
To say that our understanding of the biology of early-stage breast cancer and the management of this disease underwent significant evolution in the last quarter of the twentieth century is an understatement. During that time, the postulation of an alternative hypothesis of tumor dissemination challenged the previously accepted Halstedian principles and eventually led to the establishment of breast-conserving surgery and adjuvant systemic therapy as accepted standards of care. In addition, the introduction and widespread use of screening mammography and an increased awareness of breast cancer in the general public dramatically changed the landscape of disease presentation, allowing considerably more options for patients. As a result of these developments, since the mid-1980s there has been a worldwide, steady decline in breast cancer mortality that has persisted to date without evidence of a slowdown.
Over the past decade, there have been extraordinary developments in breast cancer research and clinical management. The introduction of molecular classification of breast cancer and the subsequent clinical application of genomic profiling in patients with early-stage disease; the adoption of sentinel node biopsy as the standard of care for staging the axilla; and the successful introduction of targeted biologic therapies, such as trastuzumab, lapatinib, and bevacizumab, in the clinic represent significant milestones in the fight against breast cancer. Improvements in imaging modalities, adjuvant endocrine therapy, and adjuvant chemotherapy have also played a major role in the continuing improvement in breast cancer outcomes.
Some of these remarkable changes have come with considerable controversy as we continue to work toward their integration into everyday clinical practice. This issue of the Surgical Oncology Clinics of North America is devoted primarily to the review and discussion of some of these new developments and areas of debate. D. Lawrence Wickerham discusses the recent advancements and remaining areas of controversy in breast cancer chemoprevention. Monica Morrow reviews promises and pitfalls with the application of MRI for screening, diagnosis, and eligibility for breast-conserving surgery. Several articles address controversial and timely topics surrounding sentinel node biopsy. Anees Chagpar discusses the clinical significance of minimal sentinel node involvement and appropriate management options, a topic that clinicians are being confronted with at tumor board conferences on a daily basis. Hiram Cody addresses controversies over the clinical significance and management of extra-axillary sentinel lymph nodes. Michael Sabel thoroughly reviews and discusses the controversial topic of timing of sentinel lymph node biopsy in patients treated with neoadjuvant chemotherapy. Bijan Ansari and Judy Boughey review current knowledge of the use of sentinel lymph node biopsy in uncommon clinical circumstances. The last two surgical articles, by Amar Gupta/Patrick Borgen and Gail Lebovic, address two areas in primary breast cancer surgery that have attracted considerable attention in the past few years, namely the role of total skin-sparing (nipple-sparing) mastectomy and the role of oncoplastic surgery.
Following the theme of treatment individualization, Joseph Sparano and his colleagues provide an excellent assessment of the current status and clinical application of gene expression profiling in early-stage breast cancer, a development that has dramatically changed how breast cancer is viewed and treated today. Subsequently, Harry Bear discusses the topic of neoadjuvant chemotherapy as a way to individualize locoregional and systemic therapy, and Matthew Ellis and colleagues address the emerging field of neoadjuvant endocrine therapy, a topic that has gained importance as the biology of breast cancer subtypes becomes better defined. Harold Burstein and Jennifer Griggs review recent developments in adjuvant endocrine therapy, one of the most successful treatments in breast cancer, and Catherine Kelly and Gabriel Hortobagyi address new developments in adjuvant chemotherapy, such as the incorporation of taxanes and the use of genomic classifiers to select appropriate chemotherapy candidates. Last but not least, George Sledge and colleagues present an outstanding discussion on the achievements and promises of biol