Documentation and audit Clear and contemporaneous documentation of patient details, clinical findings, disease characteristics and discussions regarding options for management (both with the patient and with the multidisciplinary team) is crucial for safe patient management and for demonstrating this in…
Introduction This chapter deals with some of the psychosocial issues associated with treating women with breast cancer; it is not exhaustive as the emphasis is on matters especially relevant to surgeons. We reflect on some of the most topical questions…
Introduction Gender affirmation surgery is an important step in the life journey of some gender diverse individuals (the term ‘re-assignment’ is no longer used and is considered harmful). Top (chest/breast) surgery is the most commonly pursued type of gender affirming…
Introduction In all but a few rare instances, once breast cancer has metastasised, the disease is incurable. Treatment is aimed at control of the disease, potentially prolonging life, relieving symptoms or putting off the time that symptoms may occur, aiming…
Background and history Radiotherapy involves the delivery of ionising radiation to kill malignant cells. Radiotherapy is frequently used in the management of early breast cancer. The radiotherapeutic management of early breast cancer accounts for 20–40% of available resources in most…
Introduction Over the past half century, breast cancer management has evolved from primarily surgical therapy to a multidisciplinary approach including surgery, radiation therapy and systemic therapy. This shift is based on an increased understanding of invasive breast malignancy as a…
Introduction The mortality from breast cancer has fallen by over 15% in the UK over the last 15 years, despite a rising incidence. Historically over half of women with operable breast cancer who received loco-regional treatment alone died from metastatic…
Background Ductal carcinoma in situ (DCIS) is a non-obligate precursor of invasive breast cancer in which the proliferation of malignant epithelial cells remains confined by an intact basement membrane, without invasion into the surrounding stroma. The introduction of screening mammography…
Introduction Rates of breast reconstruction following mastectomy continue to rise, despite significant geographic variation, and for complex psychosocial reasons there is a continual growth in the number of patients undergoing contralateral prophylactic (risk-reducing) mastectomy (CPM). Mastectomy for breast cancer can…
This chapter discusses uncommon diseases of the breast, including (i) pregnancy-associated breast cancer (PABC); (ii) male breast cancer (MBC); (iii) Paget’s disease of the breast; and (iv) other breast malignancies, including melanoma, lymphoma, angiosarcoma and metastases, as well as management…