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  • Image not available. Breast cancer is usually diagnosed in early stages, when it is a highly curable malignancy.
  • Image not available. Local therapy of early-stage breast cancer consists of modified radical mastectomy or lumpectomy plus external beam radiation therapy. The surgical approach to the ipsilateral axilla may consist of a full level I/II axillary lymph node dissection or a lymph node mapping procedure with sentinel lymph node biopsy.
  • Image not available. Adjuvant endocrine therapy reduces the rates of relapse and death in patients with hormone receptor-positive early breast cancer tumors. Adjuvant chemotherapy reduces the rates of relapse and death in all patients with early stage breast cancer.
  • Image not available. The choice of chemotherapy regimen, dose, schedule and duration of therapy, and the choice of endocrine therapy are controversial and rapidly changing as results from ongoing randomized clinical trials are reported.
  • Image not available. Neoadjuvant chemotherapy is appropriate for patients with locally advanced breast cancer, inflammatory breast cancer, and selected patients with early breast cancer followed by local therapy and further adjuvant systemic therapy.
  • Image not available. Initial therapy of metastatic breast cancer in most women with hormone receptor-positive tumors should consist of hormonal therapy.
  • Image not available. Women with metastatic breast cancer who have hormone receptor-positive tumors and respond to an initial hormonal manipulation will usually respond to a second hormonal manipulation.
  • Image not available. Approximately 60% of women with metastatic breast cancer will respond to chemotherapy regimens; anthracycline- and taxane-containing regimens are the most active.
  • Image not available. The goal of adjuvant chemotherapy is curative, whereas the goal of chemotherapy in the metastatic setting is palliative.
  • Image not available. Although controversial, annual screening mammography in women younger than 50 years of age is clearly beneficial and many national and international studies demonstrate a reduction in breast cancer mortality from annual or biennial screening mammography in women ages 50 to 70 years.

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Upon completion of the chapter, the reader will be able to:

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  • 1. List factors associated with an increased risk of breast cancer in the United States.
  • 2. Assess patients for signs and symptoms related to breast cancer in early and late stages of the disease.
  • 3. Explain the diagnostic plan for newly diagnosed and recurrent breast cancer in all stages of the disease.
  • 4. Discuss the staging system for breast cancer, including clinical and pathologic staging criteria for both the breast and lymph nodes.
  • 5. Critique available prognostic variables for clinical utility.
  • 6. Compare and contrast available surgical techniques for the local treatment of early and advanced stages of breast cancer.
  • 7. Determine which patient populations may benefit from adjuvant systemic therapy for breast cancer.
  • 8. Debate the risks and benefits of chemotherapy regimens used in the adjuvant treatment of breast cancer.
  • 9. Critique the available evidence regarding the use of endocrine therapy in the adjuvant treatment of breast cancer.
  • 10. Explain the clinical characteristics and basic treatment approach for inflammatory breast cancer.
  • 11. Determine the treatment goals for early stage, locally advanced, and metastatic breast cancer.
  • 12. Determine appropriate indications for endocrine therapy, chemotherapy, and biologic therapy for patients with metastatic breast cancer.
  • 13. Critique available ...

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