Facilitating breast-conserving surgery and preventing recurrence: aromatase inhibitors in the neoadjuvant and adjuvant settings.
Female; Humans; Neoadjuvant Therapy; Antineoplastic Agents/*administration & dosage; Aromatase Inhibitors/*administration & dosage; Breast Neoplasms/*drug therapy/*surgery; Neoplasm Recurrence; Segmental; *Mastectomy; Adjuvant; Chemotherapy; Local/*prevention & control
Breast-conserving surgery (BCS) is an attractive option for many patients with early-stage breast cancer, because it provides a better cosmetic outcome than modified radical mastectomy, while reducing surgical morbidity. In patients with large, operable breast tumors who are ineligible for BCS, neoadjuvant therapy is a useful option for reducing the tumor size and for increasing the proportion of candidates for BCS. In patients with endocrine-responsive tumors, neoadjuvant endocrine therapy with either tamoxifen or an aromatase inhibitor (AI; anastrozole, letrozole, or exemestane) provides an alternative to neoadjuvant chemotherapy. Clinical trials have demonstrated the superiority of neoadjuvant AIs over tamoxifen in achieving a clinical response and increasing the frequency of BCS. In addition, adjuvant endocrine therapy with AIs, whether used as initial therapy instead of tamoxifen, in a switching strategy after 2-3 years of tamoxifen, or as extended adjuvant therapy after 5 years of adjuvant tamoxifen, has been shown in several randomized clinical trials to improve disease-free survival, reduce distant metastases and, in some cases, improve overall survival. The availability of the AIs for effective and well-tolerated neoadjuvant and/or adjuvant endocrine therapy represents an important advance in breast cancer treatment, and surgeons should be familiar with these new therapeutic options.
Mamounas Eleftherios P
Annals of surgical oncology
2008
2008-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1245/s10434-007-9702-3" target="_blank" rel="noreferrer noopener">10.1245/s10434-007-9702-3</a>
Reflex sympathetic dystrophy after modified radical mastectomy: a case report.
Female; Humans; Middle Aged; Pain; Electromyography; Movement; *Postoperative Complications; Arm/physiopathology; Reflex Sympathetic Dystrophy/*etiology/physiopathology/therapy; *Mastectomy; Radical
Despite the long history of descriptions of reflex sympathetic dystrophy (RSD), much confusion remains regarding its pathogenesis, diagnosis, and treatment. It most commonly occurs after trauma and is more frequent in women, white persons, and the elderly. The first case of RSD after mastectomy is reported and the proposed pathophysiology and management of RSD are reviewed.
Saddison D K; Vanek V W
Surgery
1993
1993-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).