Книга_1157_Библиотеки_им_академика_М_И_Перельмана

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<<< < Предыдущая 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 3435 / 3535

343SUBJECT INDEX

Coracobrachialis, 7t Cording, axillary lymph node dissection

complication, 203

Core biopsy

comparison with other biopsy techniques, 48t overview, 49–51 stereotactic core biopsy, 54–56, 54b,55b,55f

technique, 50–51, 51f Cowden syndrome, breast cancer association, 105 COX-2, see Cyclooxygenase-2 Cribriform carcinoma, histology, 126 Cyclooxygenase-2 (COX-2), inhibitors, 266 Cyclophosphamide, adjuvant chemotherapy, 258t Cysts, presentation and management, 60–61

Danazol

breast pain management, 71

gynecomastia management, 99 DCIS, see Ductal carcinoma in situ Deep inferior epigastric perforator (DIEP) flap, breast

reconstruction, 215–216, 215f

Diabetic mastopathy, presentation and management,

62 DIEP flap, see Deep inferior epigastric perforator flap Distal recurrence, see Recurrence DNA microarray, adjuvant chemotherapy evaluation,

255, 255f, 256 Docetaxel

adjuvant chemotherapy, 258t, 260 mechanism of action, 259–260

neoadjuvant therapy, 282t Donut mastopexy, 228f Doxorubicin

adjuvant chemotherapy, 258t

neoadjuvant therapy, 281t Drain management, 196, 197b Duct ectasia, nipple discharge, 76 Duct excision, nipple discharge diagnosis and

management, 80–82, 81f

Ductal carcinoma in situ (DCIS)

classification

architectural classification and histology, 145f,

145t, 146f comedo versus noncomedo, 146–147 histopathological classification, 146 subtypes, 144, 144b

follow-up, 302–303, 302b incidence, 144–146 presentation, 147–148, 147f treatment

axillary lymph node biopsy and dissection,

151–152, 151b breast conservation therapy, 149–150, 149t, 150b hormone therapy, 152 lumpectomy, 150–151 mastectomy and indications, 149, 149b overview, 148–152

Ductal lavage, nipple discharge evaluation, 79–80, 79f Ductography, nipple discharge evaluation, 79, 79f Ductoscopy, 79–80, 80f,81f

Eastern Cooperative Oncology Group (ECOG),

performance scales, 329t

ECOG, see Eastern Cooperative Oncology Group

EIC, see Extensive intraductal component Elderly, breast cancer management, 329–332 Embryology, breast development, 2–3, 2b Erlotinib, 265 Estrogen

adjuvant therapy, 274 breast effects, 14, 14t gynecomastia and unintentional exposure, 94, 95b levels and breast cancer risks, 106, 270 metabolites and breast cancer, 270, 270b receptors

binding and activity, 268–270, 268f, 271f expression

pathology report, 130 subtypes, 269, 269b

selective estrogen receptor modulators

agonist versus antagonist effects, 271–274, 271b raloxifene, see Raloxifene

tamoxifen, see Tamoxifen Evening primrose oil, breast pain management, 71 Excisional biopsy

comparison with other biopsy techniques, 48t technique, 51–52, 52f

wire-localized excisional biopsy, 56–57, 56f Exemestane, adjuvant therapy, 274t, 275, 276 Extended latissimus dorsi flap, breast reconstruction,

216, 216f, 217f

Extensive intraductal component (EIC), pathology

report, 131

External abdominis oblique, 7t

Fascia, breast and chest wall, 9 Fat necrosis, presentation and management, 62 Fatigue

chemotherapy side effect, 264

management, 301t

radiation therapy complication, 240 Fibroadenoma

course, 59

cryoablation, 59, 60f

phyllodes tumor differential diagnosis, 336b

presentation, 58, 59f,60f Fibromatosis, breast, 337 Fine-needle aspiration biopsy (FNAB)

benign versus malignant findings, 49t

comparison with other biopsy techniques, 48t

ductal carcinoma in situ, 147

false results, 48

technique, 49, 50f

triple diagnosis, 47, 47t 5-Fluorouracil, adjuvant chemotherapy, 258t FNAB, see Fine-needle aspiration biopsy Follicular phase, breast changes, 15 Fractionation, radiation therapy, 239

Gail model, breast cancer risk modeling, 112, 116 Galactic band, 2 GAP flap, see Gluteal artery perforator flap Gefitinib, 265 Gemcitabine, adjuvant chemotherapy, 258t Genetic counseling

indications, 140–141, 141b

referral criteria, 304, 305b Glucocorticoids, breast effects, 14t

344 SUBJECT INDEX

Gluteal artery perforator (GAP) flap

inferior gluteal artery perforator flap, 218–219,

218f overview, 216–217 superior gluteal artery perforator flap, 217–218,

217f

Goserlin, breast pain management, 72 Grade, pathology report, 130, 130b Granulomatous mastitis, 88–90, 89t Growth hormone, breast effects, 14t Gynecomastia

clinical classification, 99t epidemiology, 91 etiology

associated conditions, 92t drugs, 94, 95t genetic disorders, 92–93 human immunodeficiency virus, 94–95 liver disease, 94 malignancy, 93–94, 93t renal failure, 94 thyroid disorders, 94

evaluation

algorithm, 98f biopsy, 96–97 history, 95–97, 96b laboratory evaluation, 97, 98t mammography, 96, 96f physical examination, 95–97

treatment

cause identification, 97, 99 medical therapy, 99 surgery, 99

Halsted’s ligament, 13 Halsted’s theory, 157, 182f Hamartoma

mammography, 23, 25f presentation and management, 61, 62f

Heat shock protein-90, therapeutic targeting, 266 Hematoma, presentation and management, 61 Her-2/neu, expression in pathology report, 130 Herceptin

adjuvant therapy, 260–262 mechanism of action, 260–262, 261b, 261f

High-risk patients

BRCA mutation patient management, 118–121,

120b decreasing risk

aromatase inhibitors, 116 aspirin, 113 lifestyle modification, 112–113 overview, 112–117, 112t prophylactic surgery

mastectomy, 116–117, 120–121

oophorectomy, 117, 121

raloxifene, 116 tamoxifen

BRCA mutations, 116

clinical trials, 113–115, 114t, 120

family history, 115

Gail model high-risk patients, 116

indications, 115–116, 115b

mechanisms, 113b

proliferative lesions, 115 lobular carcinoma in situ patient management,

117–118, 118b

High-risk patients (Continued)

risk factors, see Risk factors, breast cancer surveillance

breast examination, 119 magnetic resonance imaging, 119 mammography, 119 ultrasound, 119

Histology

adenoid cystic carcinoma, 128 apocrine carcinoma, 128 cribriform carcinoma, 126 invasive ductal carcinoma, 124, 124f invasive lobular carcinoma, 124–125, 125f medullary carcinoma, 126, 126f metaplastic carcinoma, 128 mucinous carcinoma, 126–127, 127f neuroendocrine carcinoma, 128 papillary carcinoma, 127–128, 127f secretory carcinoma, 128 tubular carcinoma, 125–126, 125f

History

breast mass evaluation, 42–43, 42b gynecomastia evaluation, 95–97, 96b invasive cancer follow-up, 303–304

nipple discharge evaluation, 76b HIV, see Human immunodeficiency virus Hormone replacement therapy (HRT), breast cancer

risks, 106–107 Hot flashes, management, 301t hPL, see Human placental lactogen HRT, see Hormone replacement therapy Human immunodeficiency virus (HIV), gynecomastia

association, 94–95 Human placental lactogen (hPL), breast effects,

14t,15

IBC, see Inflammatory breast cancer Imaging, see Computed tomography, Magnetic

resonance imaging, Mammography, Positron

emission tomography, Screening, breast cancer,

Ultrasound IMNs, see Internal mammary lymph nodes IMRT, see Intensity-modulated radiation therapy Incisional biopsy, 52–53 Induction chemotherapy, locally advanced breast

cancer, 292–293 Inferior gluteal artery perforator flap, breast

reconstruction, 218–219, 218f Inflammatory breast cancer (IBC)

diagnosis and workup, 294, 295f presentation, 293–296, 294f

treatment, 295–296, 295b Insulin, breast effects, 14t Intensity-modulated radiation therapy (IMRT),

243–244

Internal mammary lymph nodes (IMNs)

dissection, 199–201, 199f

lymphoscintigraphy, 189, 204

metastasis, 196–201

radiation therapy, 240

sentinel lymph node biopsy, 198–199, 200–201 Intraoperative radiation therapy (IORT), 244 Invasive ductal carcinoma, histology, 124, 124f Invasive lobular carcinoma, histology,

124–125, 125f

IORT, see Intraoperative radiation therapy

345SUBJECT INDEX

Karnofsky Scale, 330t Ki-67, proliferation analysis, 140

LABC, see Locally advanced breast cancer Lactation, breast changes, 16–17 Lapatinib, 265 Lateral pectoral nerve, 10, 10f Lattismus dorsi, 7t,8,9f LCIS, see Lobular carcinoma in situ Lead time bias, screening, 48, 64f Letrozole, adjuvant therapy, 274t, 275, 276 Leukemia

chemotherapy side effect, 265

radiation therapy complication, 241 Li-Fraumeni syndrome, breast cancer association, 105 Linear accelerator, 238b, 238f Lipoma, presentation and management, 61 Lipomastia, 91 Liver metastasis, resection, 319–320 Lobular carcinoma in situ (LCIS)

breast cancer risks, 109–111

histology, 110f

management, 117–118, 118b

pleomorphic lobular carcinoma in situ,

110, 110f Local recurrence, see Recurrence Locally advanced breast cancer (LABC)

definition, 290–292 diagnosis and workup, 290–291, 291f staging, 290t treatment

historical perspective, 291–292 induction chemotherapy, 292–293 local surgery, 292–293, 292b regional surgery, 293

summary, 293b Long thoracic nerve, 10, 10f Lumpectomy, see also Breast conservation therapy

breast implant patients, 170 dissection and lumpectomy, 165–167, 166f ductal carcinoma in situ management, 150–151 incision placement, 164–165, 164f oncoplastic approaches, 226–229, 227f,

228f, 229f postoperative care, 170 radiation therapy, 236–237 reexcision lumpectomy, 169–170 wire-localized lumpectomy, 167,

168f, 169f wound closure, 167

Lung cancer, radiation therapy complication, 241 Lung metastasis, resection, 318–319, 319t Luteal phase, breast changes, 16 Lymphedema

axillary lymph node dissection complication

management, 204–205 overview, 203–207 prevention, 204, 204b, 205–206 risk factors, 203b staging, 205t symptoms, 205b

treatment, 206–207 management, 301t mastectomy complication, 178 radiation therapy complication, 241

Lymphoma, breast, 339

Lymphoscintigraphy

local recurrence management, 313, 314f sentinel lymph node biopsy, 187–188, 187f, 189

189f

Lymphovascular invasion, pathology report, 130–131,

131f

Magnetic resonance imaging (MRI)

applications

breast conservation assessment, 32–33 follow-up of breast cancer patients, 34 neoadjuvant therapy, 34 occult primary breast cancer, 32 screening, 33–34, 34t

silicone breast implant imaging, 32 biopsy guidance, 57–58 breast conservation therapy patient selection, 161 breast mass evaluation, 47 contrast enhancement, 31–32 ductal carcinoma in situ, 147 invasive cancer follow-up, 306 staging of breast cancer, 135 surveillance of high-risk patients, 119 technique, 31–32, 31f

Male breast cancer

clinical presentation and workup, 324 risk factors, 324–328, 324b treatment

adjuvant chemotherapy, 325b, 328

axillary management, 328

mastectomy, 324

MammaPrint assay, 256 Mammography

applications

diagnostics, 23–26, 23t,24f,25f,26f

screening of breast cancer, 22, 22t breast mass evaluation, 46 calcifications, 24, 25f, 26, 26f,27f,28t digital mammography, 20–22, 21f guidance of interventional procedures, 26–27, 29f gynecomastia evaluation, 96, 96f invasive cancer follow-up, 304 surveillance of high-risk patients, 119 technique, 19–20 triple diagnosis, 47, 47t views

craniocaudal view, 20, 21f

mediolateral oblique view, 20, 20f,21f

table, 21t

Margin status, pathology report, 129–130 Mastalgia, see Breast pain Mastectomy

breast cancer prophylaxis, 116–117, 120–121 breast conservation therapy comparison, 159–164,

159t

complications

bleeding, 177

chronic pain, 177–178

infection, 176–177

lymphedema, 178

seroma, 177 ductal carcinoma in situ indications, 149, 149b historical perspective, 146, 157, 180, 182f inflammatory breast cancer, 295, 296 local recurrence

rates, 158t, 309t

treatment, 311–313, 312b

346 SUBJECT INDEX

Mastectomy (Continued)

male breast cancer, 324 modified radical mastectomy technique, 174–176,

174f, 175f, 176f postoperative care, 175–176 radiation therapy after surgery, 237–238, 237t simple mastectomy technique, 170–174, 171f,

172f skin-sparing mastectomy, 218f, 219–220, 219b, 220f,

221f, 222f, 223f super radical mastectomy, 159b

Mastitis

granulomatous mastitis, 88–90, 89t management, 84, 84f presentation, 83 puerperal mastitis, 83

Medial pectoral nerve, 10, 10f Medullary carcinoma

diagnostic criteria, 126b histology, 126, 126f

Menarche, age and breast cancer risks, 106 Menopause

age and breast cancer risks, 106 breast changes, 16

Menstrual cycle, breast effects

follicular phase, 15 luteal phase, 16 menstruation, 15–16

Metaplastic carcinoma, histology, 128 Metastasis

bones affected, 138b breast as metastasis site, 339–340 central nervous system symptoms, 139b chemotherapy, 321–322 M staging, 138–139 micrometastasis, 138, 140 positron emission tomography, 35, 35f, 139 surgery and stage IV disease

bone metastasis, 320–321 brain metastasis, 320 liver metastasis, 319–320 lung metastasis, 318–319, 319t outcomes, 317–321 patient selection, 317–318, 318b

treatment goals, 321b

Methotrexate, adjuvant chemotherapy, 258t Micrometastasis, 138, 140, 191f Milk streak, 2 Mitomycin-C, adjuvant chemotherapy, 258t MRI, see Magnetic resonance imaging Mucinous carcinoma, histology, 126–127, 127f

National Surgical and Adjuvant Breast Project (NSABP),

180, 181, 181t

Neoadjuvant chemotherapy

advantages, 280b breast conservation rates, 280t, 282–283 chemosensitivity test, 287–288 contraindications, 281b early delivery and survival, 287 local recurrence rates, 283–284, 284t patient selection, 282 primary surgery after chemotherapy, 284–285 regimens, 281–282, 282t sentinel lymph node biopsy after chemotherapy,

285–287, 286b, 286t tumor shrinkage, 283f

Neuroendocrine carcinoma, histology, 128 Nipple bud, 2 Nipple discharge

associated breast conditions, 75–76 clinical evaluation

algorithm, 78f ductal lavage, 79–80, 79f ductography, 79, 79f ductoscopy, 79–80, 80f,81f history, 76b occult blood testing, 79 physical examination, 76 ultrasonography, 77 unilateral discharge, 78

duct excision in diagnosis and management, 80–82,

81f endocrine causes, 75 epidemiology, 73 medication induction, 75b nipple aspirate fluid

composition, 74b

cytologic classification, 74, 74t Nipple reconstruction, 221–226, 224f NNS, see Number needed to screen NSABP, see National Surgical and Adjuvant Breast

Project Number needed to screen (NNS), 39

Onco Type DX assay, 256 Oophorectomy, breast cancer prophylaxis,

117, 121 Oral contraceptives, breast cancer risks, 107 Orr incision, 171, 172f Ovarian ablation/suppression, adjuvant therapy,

276–277, 277t Ovarian failure, chemotherapy side effect, 264–265 Oxytocin, breast effects, 14t, 15, 17

p53, breast cancer mutations, 105 Paclitaxel

adjuvant chemotherapy, 258t, 260 mechanism of action, 259–260

neoadjuvant therapy, 281t, 282t Pagetoid spread, 110f Paget’s disease

associated conditions, 153b

clinical presentation, 153–154

differential diagnosis, 153b

ductal carcinoma in situ presentation, 147f

epidemiology, 153

pathogenesis, 153, 153t

pathology, 154, 154f

treatment

algorithm, 155f no mass, 154–156

palpable mass, 154 Papillary carcinoma, histology, 127–128, 127f Papilloma

nipple discharge, 76

presentation and management, 63–65, 64f Parallelogram mastopexy lumpectomy, 227f Pathology report

breast cancer types, 124b

extensive intraductal component, 131

grade, 130, 130b

Her-2/neu expression, 130

347SUBJECT INDEX

Pathology report (Continued)

histology

tubular carcinoma, 125–126, 125f hormone receptors, 130 lymphovascular invasion, 130–131, 131f margin status, 129–130 tumor size, 129, 129f

Pectoralis major, 7t Pectoralis minor, 7t PET, see Positron emission tomography Peutz-Jeghers syndrome, breast cancer association, 105 Phyllodes tumors

fibroadenoma differential diagnosis, 336b histology, 336, 336f management, 337 presentation, 335 recurrence, 337

Physical examination

axillary examination, 182–183, 183f breast mass evaluation, 43–46, 43b,44f,45f breast pain evaluation, 69 gynecomastia evaluation, 95–97 invasive cancer follow-up, 304 nipple discharge evaluation, 76 triple diagnosis, 47, 47t

PLCIS, see Pleomorphic lobular carcinoma in situ Pleomorphic lobularcarcinoma in situ (PLCIS),110, 110f Pneumonitis, radiation therapy complication, 241 Poland’s syndrome, 3 Positron emission tomography (PET)

metastasis detection, 35, 35f, 139 technique, 34–35

Pregnancy

anesthesia, 328, 328b breast cancer

diagnosis, 326

risks, 106, 326

staging, 326–327

treatment, 327–329, 327f breast changes, 16 chemotherapy risks, 328, 328b

Progesterone

breast effects, 14, 14t receptor expression, 130, 269–270

Prolactin

breast effects, 14t, 15, 16 elevation and nipple discharge, 75, 75b secretion regulation, 15b

PTEN, breast cancer mutations, 105 Puberty, breast development, 3, 4f,4t Puerperal mastitis, 83

Race, see Ethnicity Radial scars, presentation and management, 63 Radiation therapy, see also Breast conservation therapy

benefits in breast cancer, 234–238, 234t, 235f

Radiation therapy (Continued)

breast reconstruction interactions

autologous flap

irradiation effects, 225

placement after irradiation, 226 expander/implant irradiation effects, 224–225 overview, 224–226 prosthesis placement after irradiation, 225–226

complications, 240–242 computed tomography simulation, 238, 239f delivery, 238–240 historical perspective, 232 linear accelerator, 238b, 238f lumpectomy without radiation, 236–237 mastectomy patients, 237–238, 237t mechanism of action, 232–234, 232f, 233f partial breast irradiation

brachytherapy

balloon-catheter brachytherapy, 243

interstitial brachytherapy, 242–243 intensity-modulated radiation therapy, 243–244 intraoperative radiation therapy, 244 overview, 242–244, 243t patient selection, 243b

Raloxifene, breast cancer chemoprevention, 116 Reconstruction, see Breast reconstruction Rectus abdominis, 7t Recurrence, see also Metastasis

breast conservation therapy and variables associated

with recurrence, 163–164, 163b

chemotherapy for locoregional recurrence, 315–317 definitions, 308b local recurrence

breast conservation therapy versus mastectomy,

309t diagnostic workup, 310 differential diagnosis, 309b explanations, 298–300, 300b presentation, 309–310 prognostic factors, 311b treatment

axillary lymph node dissection, 313–314,

313f breast conservation therapy, 310–311 lymphoscintigraphy, 313, 314f mastectomy, 311–313, 312b sentinel lymph node biopsy, 313–314, 313f

mastectomy and local recurrence rate, 158t neoadjuvant chemotherapy and local recurrence

rates, 283–284, 284t

patterns

distal recurrence, 299–300 local recurrence, 298–299 nonbreast cancer, 300 regional recurrence, 299

second primary breast cancers, 300, 300b phyllodes tumors, 337 regional recurrence

overview, 314–315

treatment

axillary recurrence, 315

supraclavicular recurrence, 6f, 315 Recurrent subareolar abscess, see Breast abscess Reduction mastopexy, 229f Regional recurrence, see Recurrence Retromammary space, 5 Rib fracture, radiation therapy complication, 241 Risk factors, breast cancer

antibiotic use, 111

348 SUBJECT INDEX

Risk factors, breast cancer (Continued)

breast density, 108 breast-feeding studies, 108 decreasing risk

aromatase inhibitors, 116 aspirin, 113 lifestyle modification, 112–113 overview, 112–117, 112t prophylactic surgery

mastectomy, 116–117, 120–121

oophorectomy, 117, 121 raloxifene, 116 tamoxifen

BRCA mutations, 116

clinical trials, 113–115, 114t, 120

family history, 115

Gail model high-risk patients, 116

indications, 115–116, 115b

mechanisms, 113b

proliferative lesions, 115

diet, 107–108 height and weight, 107 hereditary factors

family history, 103 gene mutations

ATM, 105

BRCA1, 103–105, 104t

BRCA2, 103–105, 104t

overview, 103–105, 103t

p53, 105

PTEN, 105

STK11, 105 race, 102

medications

hormone replacement therapy, 106–107 oral contraceptives, 107

melatonin, 111 menstrual and reproductive factors

age at menarche, 106 age at menopause, 106 hormone levels, 106 pregnancy, 106

overview, 102–111 physical inactivity, 107 previous history, 108 proliferative lesions

atypical hyperplasia, 109–111, 109f lobular carcinoma in situ, 109–111, 110f pleomorphic lobular carcinoma in situ, 110, 110f without atypia, 108–109

radiation, 111 smoking, 111 statistical models, 111–112 viruses, 111

Sarcoma, breast

angiosarcoma, 338–339 diagnosis, 338 management, 338 presentation, 338 radiation therapy complication, 241 risk factors, 337–339

Sclerosing adenosis, presentation and management,

62, 63

Screening, breast cancer

accuracy measures, 37f lead time bias, 48, 64f

Screening, breast cancer (Continued)

magnetic resonance imaging, 33–34, 34t,39 mammography, 22, 22t number needed to screen, 39 principles, 36b, 38–39 recommendations, 38–39, 38b sojourn time, 36, 37b

terminology, 36b Secretory carcinoma, histology, 128 Sentinel lymph node biopsy (SLNB)

breast reconstruction considerations, 226

complications

dye allergy, 201–202 finding sentinel node, 201

surgical complications, 202 contraindications, 184–186, 185b ductal carcinoma in situ, 151–152, 151b histopathological examination, 190–191, 191f internal mammary lymph nodes, 198–199,

200–201 intraoperative evaluation, 189–190, 190b local recurrence management, 313–314, 313f lymphadenectomy, 188–190, 188f, 189f lymphoscintigraphy, 187–188, 187f, 189b, 189f neoadjuvant chemotherapy, 285–287, 286b,

286t postoperative care, 190 tracer injection, 186–188, 187t

Seroma, mastectomy complication, 177 Serratus anterior, 7t Skin-sparing mastectomy, 218f, 219–220,

219b, 220f, 221f, 222f, 223f SLNB, see Sentinel lymph node biopsy Smoking

breast abscess risks, 87b

breast cancer risks, 111 Squamous metaplasia, 128 Staging, breast cancer

clinical staging of axilla, 182f

locally advanced breast cancer, 290t

M stage, 138–139

magnetic resonance imaging, 135

N stage, 136–138, 137t, 138t

overview, 133–140

pregnancy breast cancer, 326–327

stage grouping, 138t

T stage, 134–136, 135t

tumor board presentation, 141–142

ultrasound, 30, 30 Stewart incision, 166, 171f STK11, breast cancer mutations, 105 Subareolar abscess, see Breast abscess Subclavius, 7t,8 Subscapularis, 7t Superior gluteal artery perforator flap, breast

reconstruction, 217–218, 217f

Surveillance

ductal carcinoma in situ, 302–303, 302b

goals, 298b

high-risk patients

breast examination, 119 magnetic resonance imaging, 119 mammography, 119 ultrasound, 119

invasive cancer follow-up

bone scintigraphy, 305–306 genetic counseling referral criteria, 304, 305b history, 303–304 magnetic resonance imaging, 306

349SUBJECT INDEX

Surveillance (Continued)

mammography, 304 physical examination, 304

limitations

blood tests, 305 chest film, 305 imaging, 305–306

patterns of recurrence

distal recurrence, 299–300 local recurrence, 298–299 nonbreast cancer, 300 regional recurrence, 299 second primary breast cancers, 300, 300b

Suspensory ligament of the axilla, 13

Tail of Spence, 3 Tamoxifen

adjuvant therapy

benefits, 272–273, 273t risks, 273

breast cancer chemoprevention

BRCA mutations, 116 clinical trials, 113–115, 114t family history, 115 Gail model high-risk patients, 116 indications, 115–116, 115b mechanisms, 113b

proliferative lesions, 115 breast pain management, 72 ductal carcinoma in situ management,

152, 152t lobular carcinoma in situ management, 118 male side effects, 325b neoadjuvant therapy, 281t

Tanner stages, 4t Thiotepa, adjuvant chemotherapy, 258t Thoracodorsal nerve, 11

Thymidine labeling index (TLI), proliferation

analysis, 140 Thyroid hormone, breast effects, 14t TLI, see Thymidine labeling index TNM system, see Staging, breast cancer TRAM, see Transverse rectus abdominis

myocutaneous flap Transverse rectus abdominis myocutaneous flap

(TRAM), breast reconstruction

blood supply, 212f free flap, 214–215, 214f patient selection, 212

technique, 213–214, 214f Trastuzumab, see Herceptin Triple diagnosis, 47, 47t Tubular carcinoma, histology, 125–126, 125f Tumor board

participants, 141b

presentation of case, 141–142 Tumor size, pathology report, 129, 129f Tyler-Cuzick model, breast cancer risk modeling, 112

Ultrasound

applications

guidance of interventional procedures, 30–31,

53–54, 53f mass evaluation, 28, 29–30, 29f,29t,30f staging of breast cancer, 30, 30f

axillary lymph nodes, 183–184, 184f, 184t biopsy guidance, 53–54, 53f breast mass evaluation, 46 nipple discharge evaluation, 77 surveillance of high-risk patients, 119 technique, 27–29

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