Mastectomy is the medical term for the surgical removal of one or both breasts,partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases,women believed to be at high risk of breast cancer have the operation as a preventive measure. Alternatively,some women can choose to have a wide local excision,also known as a lumpectomy,an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer,targeting the area of the tumor,as opposed to systemic therapies,such as chemotherapy,hormonal therapy,or immunotherapy.
Lymphadenectomy, or lymph node dissection, is the surgical removal of one or more groups of lymph nodes. It is almost always performed as part of the surgical management of cancer. In a regional lymph node dissection,some of the lymph nodes in the tumor area are removed;in a radical lymph node dissection,most or all of the lymph nodes in the tumor area are removed.
Lumpectomy is a surgical removal of a discrete portion or "lump" of breast tissue,usually in the treatment of a malignant tumor or breast cancer. It is considered a viable breast conservation therapy,as the amount of tissue removed is limited compared to a full-breast mastectomy,and thus may have physical and emotional advantages over more disfiguring treatment. Sometimes a lumpectomy may be used to either confirm or rule out that cancer has actually been detected. A lumpectomy is usually recommended to patients whose cancer has been detected early and who do not have enlarged tumors. Although a lumpectomy is used to allow for most of the breast to remain intact,the procedure may result in adverse affects that can include sensitivity and result in scar tissue,pain,and possible disfiguration of the breast if the lump taken out is significant. According to National Comprehensive Cancer Network guidelines,lumpectomy may be performed for ductal carcinoma in situ (DCIS),invasive ductal carcinoma,or other conditions.
The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasizing cancer cells from the tumor.
Radical mastectomy is a surgical procedure involving the removal of breast,underlying chest muscle,and lymph nodes of the axilla as a treatment for breast cancer. Breast cancer is the most common cancer among women today,and used to be primarily treated by surgery,particularly during the early twentieth century when the mastectomy was developed with success. However,with the advancement of technology and surgical skills,the extent of mastectomies has been reduced. Less invasive mastectomies are employed today in comparison to those in the past. Nowadays,a combination of radiotherapy and breast conserving mastectomy are employed to optimize treatment.
The axillary lymph nodes or armpit lymph nodes are lymph nodes in the human armpit. Between 20 and 49 in number,they drain lymph vessels from the lateral quadrants of the breast,the superficial lymph vessels from thin walls of the chest and the abdomen above the level of the navel,and the vessels from the upper limb. They are divided in several groups according to their location in the armpit. These lymph nodes are clinically significant in breast cancer,and metastases from the breast to the axillary lymph nodes are considered in the staging of the disease.
Umberto Veronesi was an Italian oncologist,physician,scientist and politician,internationally known for his contributions on prevention and treatment of breast cancer throughout a career spanning over fifty years.
A micrometastasis is a small collection of cancer cells that has been shed from the original tumor and spread to another part of the body through the lymphovascular system. Micrometastases are too few,in size and quantity,to be picked up in a screening or diagnostic test,and therefore cannot be seen with imaging tests such as a mammogram,MRI,ultrasound,PET,or CT scans. These migrant cancer cells may group together to form a second tumor,which is so small that it can only be seen under a microscope. Approximately ninety percent of people who die from cancer die from metastatic disease,since these cells are so challenging to detect. It is important for these cancer cells to be treated immediately after discovery,in order to prevent the relapse and the likely death of the patient.
Breast cancer management takes different approaches depending on physical and biological characteristics of the disease,as well as the age,over-all health and personal preferences of the patient. Treatment types can be classified into local therapy and systemic treatment. Local therapy is most efficacious in early stage breast cancer,while systemic therapy is generally justified in advanced and metastatic disease,or in diseases with specific phenotypes.
Breast-conserving surgery (BCS) refers to an operation that aims to remove breast cancer while avoiding a mastectomy. Different forms of this operation include:lumpectomy (tylectomy),wide local excision,segmental resection,and quadrantectomy. BCS has been increasingly accepted as an alternative to mastectomy in specific patients,as it provides tumor removal while maintaining an acceptable cosmetic outcome. This page reviews the history of this operation,important considerations in decision making and patient selection,and the emerging field of oncoplastic breast conservation surgery.
Uschi Keszler's Pennies in Action Cancer Research Fund,holding a full 501(c)(3) non-profit foundation status,exists to support research for breast cancer curative programs,including preventative vaccines and other biological therapies that do not damage the immune system.
Professor Gordon C Wishart FRCS (Eng.) FRCS (Gen.) is the founder,Chief Medical Officer,and CEO of Check4Cancer,an early cancer detection and prevention company. In 2016,Check4Cancer launched rapid access,streamlined,and audited diagnostic pathways for breast and skin cancer for the insured and self-pay markets,leading to the award of “Diagnostic Provider of the Year”at the annual Health Investor Awards in 2018. In late 2017,Check4Cancer launched the first worldwide breast cancer risk test to combine genetic,family history,and lifestyle risk factors to underpin a risk-stratified breast screening programme.
A gamma probe is a handheld device containing a scintillation counter,for intraoperative use following injection of a radionuclide,to locate sentinel lymph nodes by their radioactivity. It is used primarily for sentinel lymph node mapping and parathyroid surgery. Gamma probes are also used for RSL,to locate small and non-palpable breast lesions.
Bernard Fisher was an American surgeon and a pioneer in the biology and treatment of breast cancer. He was a native of Pittsburgh. He was Chairman of the National Surgical Adjuvant Breast Project at the University of Pittsburgh School of Medicine. His work established definitively that early-stage breast cancer could be more effectively treated by lumpectomy,in combination with radiation therapy,chemotherapy,and/or hormonal therapy,than by radical mastectomy.
Deborah M. Axelrod is an American surgeon who specializes in breast cancer.
Souzan El-Eid is a breast surgical oncologist at Comprehensive Cancer Centers of Nevada (CCCN),and serves as the medical director of the Breast Care Center at Summerlin Hospital,cancer liaison physician for the cancer program and co-chair of the Breast Tumor Board at Summerlin Hospital. She is also the president elect for Clark County Medical Society. She is an Adjunct Associate Professor of General Surgery at Touro University Nevada and has served as principal investigator for several clinical research studies. She is the first breast surgeon in Las Vegas certified in both ultrasound and stereotactic breast biopsies.
Elisa Rush Port FACS is Associate Professor of Surgery at the Icahn School of Medicine at Mount Sinai Hospital,as well as cofounder and director of the Dubin Breast Center at the Tisch Cancer Institute at Mount Sinai Health System,since 2010. She has received four research grants,has served as an investigator or co-investigator on 15 clinical trials,published 44 peer-reviewed articles,and published a total of 12 book chapters and books. She has specialized in sentinel-node biopsy,a diagnostic method that determines cancer stages based on spread to regional lymph nodes,nipple sparing mastectomy,and the use of MRI for breast cancer.
Axillary dissection is a surgical procedure that incises the axilla,usually in order to identify,examine,or take out lymph nodes. The term "axilla" refers to the armpit or underarm section of the body. The axillary dissection procedure is commonly used in treating the underarm portion of women who are dealing with breast cancer. The lymph nodes located in the axilla area that are affected by breast cancer are called the guardian or sentinel lymph nodes. Lymph nodes are essential to the lymphatic/immune system due to their main function of filtering unrecognized particles and molecules. The idea of treating breast cancer with the axillary dissection procedure was introduced in the 18th century and was backed by German physician Lorenz Heister. There are certain criteria that make patients eligible candidates for this procedure. Patients tend to have three different levels of axillary lymph nodes;the level helps to determine whether or not the patient should undergo axillary dissection.
Anne Louise Rosenberg is an American surgical oncologist retired from practice in Cherry Hill,New Jersey.
Emilia Dauway MD,FACS,FRACS is an American trained surgeon who is practicing general,breast and oncologic surgery in Australia. Dauway was co-inventor of the use of radioactive seeds in the breast to localise non-palpable breast cancers and the first in Australia to use magnetic seeds instead of radioactive seeds. This technique replaces hookwire or needle localisation improving patient safety,outcomes and satisfaction. The method was patented by the University of South Florida while Dauway was a fellow of surgical oncology. The method has been used since 1999 and has improved with the development of modern equipment. Dauway is also a Yoga Instructor,a Keynote speaker and is founder/director of Restore More,a non-profit initiative which provides education and funding to women in regional and geographically disadvantaged areas for breast cancer treatment and reconstruction.
