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Surgical Options for the Treatment of Breast Cancer Helen Krontiras, M.D. Assistant Professor University of Alabama School of Medicine

History Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Risk factors for breast cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Breast Imaging ,[object Object],[object Object],[object Object]

Biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Histology ,[object Object],[object Object],[object Object],[object Object]

Lobular Carcinoma in situ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ductal Carcinoma in situ ,[object Object],[object Object],[object Object],[object Object]

Invasive ductal carcinoma ,[object Object],[object Object],[object Object]

Invasive lobular carcinoma ,[object Object],[object Object],[object Object]

Inflammatory breast cancer ,[object Object],[object Object],[object Object],[object Object]

Paget’s Disease ,[object Object],[object Object],[object Object],[object Object]

Phyllodes Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object]

Earlier stage - better survival Stage

Lumpectomy + Mastectomy Neoadjuvant Chemotherapy (SLN BX before,surgery after) Clinical Stage I or II Invasive Breast Cancer SLN BX AND Total + SLN BX Modified Radical

Mastectomy Neoadjuvant Chemotherapy ClinicalStage III Invasive Breast Cancer Radiation Therapy

Breast Cancer Treatment Local Systemic

Local Therapy Surgery Radiation Therapy

Breast ,[object Object],[object Object],[object Object]

Mastectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Mastectomy with reconstruction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Breast Conservation Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

BCT vs Mastectomy ,[object Object],[object Object],[object Object]

Radiation Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Contraindications to breast conservation therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Contraindications to breast conservation therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],Winchester et al, Ca Cancer J Clin, 1998

Contraindications to breast conservation therapy ,[object Object],[object Object],[object Object],[object Object]

Neoadjuvant chemotherapy ,[object Object],[object Object],[object Object],[object Object]

Therapy of Regional Nodes ,[object Object],[object Object]

Axillary Node Dissection ,[object Object],[object Object],[object Object]

Silverstein, The Breast Journal 4:324, 1998 Positive axillary lymph node versus T stage

Sentinel node biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Systemic Therapy Cytotoxic Chemotherapy Endocrine Monoclonal antibody

Adjuvant therapy ,[object Object]

Adjuvant therapy recommendation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chemotherapy ,[object Object],[object Object]

SERM Selective estrogen receptor modulators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Aromatase inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Herceptin (trastuzumab) ,[object Object],[object Object],[object Object],[object Object]

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