ABC of Breast Diseases E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: ABC Series
• Sprache: Englisch

Seitenzahl: 377

Veröffentlichungsjahr: 2012

Beschreibung

The ABC of Breast Diseases provides comprehensive guidance to the assessment of symptoms, and how to manage all common breast conditions and provides guidelines on referral. It covers congenital problems, breast infection and mastalgia, before addressing the epidemiology, prevention, screening and diagnosis of breast cancer. It outlines the treatment and management options for breast cancer within different groups and includes new chapters on the genetics, prevention, management of high risk women and the psychological aspects of breast diseases.

Edited and written by internationally renowned experts in the field and highly illustrated in full colour, this fourth edition remains a practical guide for general practitioners, family physicians, practice nurses and breast care nurses as well as for surgeons and oncologists both in training and recently qualified as well as medical students.

Leseprobe

Table of Contents

Title Page

Copyright

Contributors

Preface

Chapter 1: Symptoms, Assessment and Guidelines for Referral

Assessment of Symptoms

Accuracy of Investigations

Triple Assessment

Delay in Diagnosis

One-Stop Clinics

Investigation of Breast Symptoms

Further reading

Chapter 2: Congenital Problems and Aberrations of Normal Development and Involution

Congenital Abnormalities

Breast Development and Involution

Management of Discrete Mobile Masses in Young Women

Aberrations in the Early Reproductive Period: Pain and Nodularity

Aberrations of Involution: Palpable Breast Cysts

Sclerosing Lesions

Duct Ectasia

Benign Disease in Men: Gynaecomastia

Benign Neoplasms and Proliferations: Epithelial Hyperplasia

Duct Papillomas

Lipomas

Nipple Conditions

Haematomas

Fat Necrosis

Mondor's Disease

Hamartomas

Blocked Montgomery's Tubercles

Para Areola Cysts

Morphea

Arteritis and Aneurysm

Sarcoidosis

Keloids of the Breast Skin

Wegener's Granulomatosis

Further reading

Chapter 3: Mastalgia

Chest Wall Pain

Chronic Pain Following Breast Surgery

True Mastalgia

Conclusion

Acknowledgement

Further reading

Chapter 4: Breast Infection

Treatment

Neonatal Infection

Lactating Infection

Non-Lactating Infection

Skin-Associated Infection

Other Infections and Inflammatory Conditions

Lymphocytic Lobulitis

Factitial Disease

Further reading

Chapter 5: Breast Cancer: Epidemiology, Risk Factors and Genetics

Risk Factors for Breast Cancer

Risk Estimation

The Breast Cancer Genes

Genetic Testing

Previous Benign Breast Disease

Radiation

Lifestyle

Oral Contraceptive (OC)

Hormone Replacement Therapy (HRT)

Further reading

Chapter 6: Prevention of Breast Cancer

Management Options

Prophylactic Surgery

Ovarian Cancer

Men with BRCA1 and BRCA2 Mutations

Further reading

Chapter 7: Screening for Breast Cancer

Population Screening

Screening High-Risk Groups

Benefits and Potential Drawbacks of Screening

Psychological Morbidity Induced by Screening

Risks of Mammography

Further reading

Chapter 8: Breast Cancer

Classification: Invasive Breast Cancer

Tumour Differentiation

Oestrogen Receptor

Progesterone Receptor

Human Epidermal Growth Factor Receptors

Other Features

Staging of Invasive Breast Cancers

Surgical Treatment of Localised Breast Cancer

Follow-Up of Patients after Surgery

Radiotherapy

Further reading

Chapter 9: Management of Regional Nodes in Breast Cancer

Lymph Drainage of Breast

Identifying Patients with Involved Nodes Before Surgery

Role of Axillary Surgery in Patients with Operable Breast Cancer

Staging the Axilla

Assessment of Sentinel Nodes

Treatment of Axillary Disease

Treatment of Internal Mammary and Supraclavicular Nodes

Physical Management of Lymphoedema

Presentation of Breast Cancer with Enlarged Axillary Nodes (Figure 9.21)

Treatment of Axillary Recurrence

Acknowledgements

Further reading

Chapter 10: Breast Cancer: Treatment of Elderly Patients and Uncommon Conditions

Operable Tumours Suitable for Breast Conservation

Operable Tumours Suitable for Mastectomy

Locally Advanced Breast Cancer

Radiotherapy

Adjuvant Systemic Therapy

Metastatic Disease

Very Elderly or Infirm Patients

Paget's Disease of the Nipple

Breast Cancer and Pregnancy

Male Breast Cancer

Other Rare Neoplasms

Further reading

Chapter 11: Role of Systemic Treatment of Primary Operable Breast Cancer

Endocrine Therapies

Side Effects: Endocrine Therapy (Table 11.2)

Side Effects: Chemotherapy (Table 11.2)

Selection of Adjuvant Treatment (Table 11.4)

Premenopausal Hormone Therapy

Neoadjuvant Chemotherapy and Endocrine Therapy

Neoadjuvant Endocrine Treatment

Neoadjuvant Chemotherapy

Neoadjuvant Trastuzumab

Neoadjuvant Lapatinib and Pertuzumab

Multidisciplinary Teams

Further reading

Chapter 12: Locally Advanced Breast Cancer

Classification

Prognosis of Locally Advanced Breast Cancer

Role of Systemic and Local Treatment

Choice of Systemic Treatment

Chemotherapy

Hormonal Therapy

Radiotherapy

Surgery

Management of Residual Disease

Further reading

Chapter 13: Metastatic Breast Cancer

Treatment of Metastatic Disease

Specific Problems

Control of Pain

Further reading

Chapter 14: Prognostic Factors

Clinical Factors

Histological Factors (Table 14.2)

Prognostic Indices

Biological Factors

Future

Acknowledgements

Further reading

Chapter 15: Psychological Impact of Breast Cancer

Breaking Bad News

Adjustment to the Diagnosis of Breast Cancer

Life Changes and Coping Strategies

Psychological Morbidity

Effects of Treatment

Support in Decision Making

Names and Addresses of Self-Help Groups

Further reading

Chapter 16: Carcinoma in situ

Carcinoma in situ

Ductal Carcinoma in situ

Radiotherapy after Breast-Conserving Surgery for DCIS

Margin Width

Factors Predicting Recurrence after Wide Local Excision of Ductal Carcinoma in situ (Table 16.4)

Adjuvant Endocrine Therapy

Lobular Intraepithelial Neoplasia (Lobular Carcinoma in situ/Atypical Lobular Hyperplasia)

Acknowledgement

Further reading

Chapter 17: Breast Reconstruction

Treatment Options (Table 17.1)

Complications with Breast Prostheses: Capsular Contracture

Myocutaneous Flap Reconstructions

Choice of Technique

Nipple Reconstruction

Radiotherapy

Reduction Mammoplasty and Mastopexy

Other Operations

Reconstruction after Wide Local Excision

Fat Transfer

Revision Operations

Breast Cancer after Cosmetic Breast Augmentation (Figure 17.34)

Further reading

Index

This edition first published 2012, © 2012, 2006 by Blackwell Publishing Ltd.

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First published 1995

Second edition 2000

Third edition 2006

Fourth edition 2012

Cover image: Breast cancer, mammogram. © Zephyr/Science Photo Library

Cover design: Meaden Creative

Library of Congress Cataloging-in-Publication Data

ABC of breast diseases / edited by J. Michael Dixon.—4th ed.

p. ; cm.—(ABC series)

Includes bibliographical references and index.

ISBN 978-1-4443-3796-9 (pbk. : alk. paper)

I. Dixon, J. M. (J. Michael) II. Series: ABC series (Malden, Mass.)

[DNLM: 1. Breast Diseases. 2. Breast Neoplasms. WP 840]

616.99′449–dc23

Contributors

Nigel Bundred

Professor of Surgical Oncology, Academic Department of Surgery, University Hospital of South Manchester, Manchester, UK

Jack Cuzick

Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK

J Michael Dixon

Professor of Surgery and Consultant Surgeon, Edinburgh Breast Unit; Clinical Director Breakthrough Research, Western General Hospital, Edinburgh, UK

Gareth Evans

Genetic Medicine, St Mary's Hospital, Manchester, UK

Belinda Hacking

Consultant Clinical Psychologist and Head of Clinical Health Psychology, Western General Hospital, Edinburgh, UK

Julie Iddon

East Lancashire Hospitals NHS Trust, Lancashire, UK

AA Kotsori

Clinical Fellow, Breast Unit, Royal Marsden Hospital, London, UK

Ava Kwong

Chief of Division of Breast Surgery, Queen Mary Hospital, The University of Hong Kong; Chairman, The Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong; Visiting Associate Professor Department of Oncology, Stanford University School of Medicine, USA

Robert Leonard

Professor of Medical Oncology, South West Wales Cancer Institute, Singleton Hospital, Swansea, UK

Douglas Macmillan

Oncoplastic Breast Surgeon, Nottingham Breast Institute, City Hospital, Nottingham, UK

Julietta Patnick

Director, NHS Cancer Screening Programmes, Oxford University, Oxford, UK

Sarah Pinder

King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK

Cameron Raine

Consultant Plastic Surgeon, St John's Hospital, Livingston, UK

Richard Sainsbury

Consultant Surgeon and Honorary Reader in Surgery Department; Princess Anne Hospital, Southampton, UK

Ivana Sestak

Statistician, Wolfson Institute of Preventive Medicine, Centre for Cancer Prevention, Queen Mary University of London, UK

Ian Smith

Consultant Medical Oncologist and Head of Breast Unit, Royal Marsden Hospital and Institute of Cancer Research, UK

Jeremy Thomas

Consultant Pathologist, Pathology Department, Western General Hospital, Edinburgh, UK

Alastair Thompson

Professor of Surgical Oncology, Centre for Oncology & Molecular Medicine, Ninewells Hospital & Medical School, Dundee, UK

Eva M Weiler-Mithoff

Preface

The incidence of breast cancer continues to increase year on year but thankfully the number of women who die from breast cancer continues to fall. Arguments surround how much of this reduction is due to earlier detection and how much is due to better treatments, but the falling death rate suggests that the vast amounts of money that has been invested in breast cancer is paying dividends. All this investment in research and clinical trials has resulted in an explosion of literature and keeping up to date with the latest advances in the treatment of benign and malignant breast conditions has never been more difficult. The aim of the fourth edition of the ABC of Breast Diseases has been to combine this new knowledge together with what we already knew in a concise, short, evidence based well illustrated book. Despite being compact, it is nonetheless comprehensive and I have tried to include everything even a breast disease specialist might want to know. My aim was also to make it of practical use to doctors in primary care, so the text covers guidelines for referral and management of common benign conditions which are much more frequently seen in general practice than is breast cancer. The numerous pictures make it equivalent in scope to many atlases of breast disease. If you see something related to the breast that you do not recognise the chances are there is a picture of it in the ABC.

There have been many changes since the last edition. New chapters by new authors have been added on the epidemiology of breast cancer, genetics, prevention, management of high risk women and psychological aspects of breast disease. The chapter on systemic therapy of early breast cancer has also been completely rewritten and all other chapters have been revised extensively. New authors have been added to some of these chapters and many new illustrations, tables and graphs have been included.

I write or edit many textbooks on breast disease but the one I use most frequently in my daily clinical practice is the ABC. I use it as an aide memoire and to find it useful in discussions with patients, students and staff in breast clinics. I hope others in primary care and in all branches of hospital practice find this new edition of value and even more informative than the third edition.

Thanks to all who have made the book possible. The authors as always have done all that was asked of them. Monica McGill helped interpret my edits, coordinate the many images, and made sure the book arrived at the publishers in a timely and orderly manner. Keerthana Panneer, typesetter and Sally Osborne, copy editor at Wiley-Blackwell converted the authors' words, my scribbles and the many pictures and tables into the book that you now read. Books take an enormous amount of time and I acknowledge the support my wife Pam and my sons Oliver and Jonathan for their patience while I wrote and edited at home. Most of the clinical photographs are from patients in Edinburgh and I want to personally thank all the women and a few men who agreed to be photographed and signed the medical photography forms to allow me to use their photographs in this book. My patients are my inspiration and the main reason I do what I do. They understand that in the field of breast diseases there is much we do not know. They are also aware however that there is much we do know and they want their doctors to deliver optimal management and treatments that are effective and evidenced based. That brings me full circle and explains why an updated version of the ABC outlining the current optimal approach to the management of patients with benign and malignant breast conditions is needed.

Mike DixonEdinburgh

Chapter 1

Symptoms, Assessment and Guidelines for Referral

J Michael Dixon1 and Jeremy Thomas2

1Edinburgh Breast Unit, Western General Hospital, Edinburgh, UK2Pathology Department, Western General Hospital, Edinburgh, UK

Overview

Breast conditions account for approximately 25% of all surgical referralsGuidelines for referral exist to ensure that patients with breast cancer do not suffer delays in referralCancer can present as localised nodularity, particularly in young womenAll discrete masses and the majority of localised asymmetric nodularities require triple assessmentDelay in diagnosis of breast cancer is the single largest cause for medicolegal complaints

One woman in four is referred to a breast clinic at some time in her life. A breast lump, which may be painful, and breast pain constitute over 80% of the breast problems referred to hospital and breast problems constitute up to a quarter of all female surgical referrals (Table 1.1).

Table 1.1 Prevalence of presenting symptoms in patients attending a breast clinic.

When a patient presents with a breast problem the question for the general practitioner is: ‘Is there a chance that cancer is present and, if not, can I manage these symptoms myself?’ (Figure 1.1; Tables 1.2 and 1.3).

Figure 1.1 Bathsheba by Rembrandt. Much discussion surrounds the shadowing and possible distortion of the left breast and whether this represents an underlying malignancy. Such findings would be an indication for hospital referral.