Atypical Breast Proliferative Lesions And Benign Breast Disease

Management of atypical breast lesions continues to evolve. There is considerable controversy as to whether these entities represent risk factors for future breast cancer or whether they are instead precursor lesions. A better understanding of the prognostic and therapeutic implications of each of these lesions is important for assessing subsequent breast cancer risk. Risk assessment tools are available for screening high risk patients and understanding the utility and limitations of these tools is important for all clinicians involved in the care of patients. There have been significant advances in breast cancer screening in the last several year including breast tomosynthesis, automated breast ultrasound, molecular imaging, as well as accelerated breast MRI protocols. This has raised the question: Do women at risk for breast cancer need additional breast cancer screening using these newer imaging modalities? In addition, with these advances in imaging, can women with atypical proliferative lesions be observed rather than undergoing surgical excision as some suggest? The role of observation, surgical excision and even prophylactic mastectomy in women with atypical proliferative lesions continues to be debated; however there is data that can guide physicians in the management of these patients. Pleomorphic Lobular carcinoma in-situ (PLCIS) is a distinct pathological entity within LCIS and there is no consensus regarding surgical margins or the need for adjuvant treatment to prevent recurrence. Recently, ductal carcinoma in-situ (DCIS) has been the subject of much controversy: is it truly a cancer or is it instead a precursor lesion. The traditional management of DCIS with lumpectomy and radiation is now being debated and recent data demonstrates that low grade DCIS can be managed with observation. Clinical trials are now accruing patients with low and intermediate grade DCIS to observation and close surveillance, and not surgical excision. Finally, new guidelines for chemoprevention with the use of tamoxifen and raloxifen for women with atypical proliferative lesions, LCIS, PLCIS, and DCIS are available and should be discussed as an option when guiding management of these patients. This book will provide a comprehensive review of this field and will serve as a valuable resource for clinicians, general surgeons, breast surgeons and surgical oncologists, as well as researchers with an interest in the management of atypical breast lesions. The book will review new data about breast cancer, risk factors for breast cancer, pathological features unique to each entity, the characteristic findings on imaging, risk stratification for genetic testing, as well as the current evidence-based management of each of these breast lesions. Our text will provide assessment tools for risk prediction of breast cancer. We will provide data on the current imaging modalities, as well as advanced screening options available for diagnosis and following these patients. Current management of many of these lesions continues to be controversial in regard to observation with close surveillance versus the need for surgical excision of these lesions based on future risk or whether these lesions are precursor lesion. For ductal carcinoma in-situ, the debate continues in regards to whether this disease entity is a precursor lesion that can be managed with observation or hormonal therapy, or is DCIS cancer and treated with lumpectomy and radiation. Several studies have been published where patients are managed with observation and treatment with hormonal therapy before surgical management. New trials have already begun accruing patients with low to intermediate grade DCIS where patients will be managed with observation versus hormonal therapy only. Management of DCIS continues to evolve and current management will be discussed This text will provide a concise but comprehensive summary of the current management of patients with atypical breast proliferative lesions and some benign breast lesions and will help guided management of these patients. All chapters in this text will be written by experts in the field in each of these disease entities. They will all include the most up to date research and clinical information to enhance our understanding and treatment of patients.

The second edition of this book has been extensively revised and updated. There has been a lot of scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has been rectified. New symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscess, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumour, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions which in breast cancer is becoming part of personalised medicine has been included. The book includes detailed analysis of the main models such as the Gail Model used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions. These indeterminate mammographic lesions are invariably pathologically benign. The author collated important benign lesions and based on peer-reviewed publications documented the relative risk of subsequent cancer to allow the patient and the clinician to institute preventative measures where possible. This book therefore will be an essential part of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

Preneoplasia of the Breast: presents the latest developments in the field, emphasizing cell-biological processes and depicting how they contribute to a better understanding and diagnosis of benign and malignant proliferative breast disease. is outstanding in its design, depicting over 540 full-color photomicrographs of conventional hematoxylin-eosin and immunohistochemical stainings. provides conceptual diagrams for a clearer understanding of the associated cellular processes. details the relevant radiologic, clinical and therapeutic background, clearly depicting how the pathologist can contribute to improved treatment of breast disease. contains contributions from renowned European and American pathologists and clinicians.

Breast cytopathology is a field characterized by practicality and diagnostic efficacy. This book focuses mainly on morphology, with helpful hints for recognizing benign lesions and the main features of malignancy. It reviews specific features of various lesions and the consequences of the diagnosis for the management of the patient. Each chapter contains high-quality cytology images accompanying the descriptions, including comparison images to distinguish the most important morphological features and to help in the differential diagnosis. Fine needle aspiration cytology (FNAC) sampling and preparation technique, fixation, staining, and principles of its interpretation are covered. Immunocytochemistry and ancillary techniques are outlined, as well as the main clinical and radiological features of breast lesions, and the cytological diagnostics of axillary lymph nodes. This publication will be of great use to medical practitioners in their first approach to breast cytopathology, as well as to pathologists and cytotechnicians with little to moderate experience in the field.

Completely revised and updated, and now in full color throughout, the Fourth Edition of this definitive reference is a must for all clinicians who treat breast diseases. Leading experts summarize the current knowledge of breast diseases, including their clinical features, management, underlying biologies, and epidemiologies. In addition to complete coverage of malignant breast diseases, benign diseases are discussed in relation to subsequent breast cancer development. The book reviews all major clinical trials and summarizes the information they provide on early detection and management of breast cancer. Close attention is also given to the increasing importance of molecular biology and genetics in this field. This edition features more than thirty new contributors, fourteen new or completely rewritten chapters, and more clinically oriented chapters. A companion Website will offer the fully searchable text and an image bank. Also included with this edition is the Anatomical Chart Company's Breast Anatomy and Disorders Pocket Guide. This durable, portable folding pocket guide provides a visual and textual overview of breast anatomy, disorders, and breast self-examination. With a write-on, wipe-off laminated surface, this guide is perfect for the on-the-go practitioner to show patients, caregivers, and families.

Widely recognized as the gold standard reference in the field, Rosen’s Breast Pathology provides comprehensive, up-to-date information on diseases of the breast from renowned experts at four leading medical centers, masterfully edited by Dr. Paul P. Rosen. The revised fifth edition covers the latest advances in immunohistochemical, pathobiological, and molecular aspects of benign and malignant breast diseases, helping you reach an accurate diagnosis with confidence. It’s an ideal reference for all physicians and medical personnel who require a thorough knowledge of breast pathology, including pathologists, surgeons, oncologists, radiologists, and radiation oncologists.

Rather than an exhaustive review of all the pathologic conditions of the female breast, Breast Cancer and its Precursor Lesions focuses on the current knowledge, understanding and issues related to breast cancer and its benign lesions that are associated with an increased risk for the subsequent development of cancer. This book targets the language, diagnostic terms and critical communication that must take place between primary care physicians, breast surgeons, oncologists, and general surgical pathologists interested in the pathologist’s perspective on these important diseases. The volume also reviews the current terminology and how to read or write meaningful pathology reports on these entities, the foils and nuances of the pathology and implications for management, and up to date issues in genomics and proteomics of these conditions. The text is succinct, fully informative, and written in “plain language”. All chapters are presented in a uniform fashion, and supplemented by high-quality illustrations and tables. Breast Cancer and its Precursor Lesions will be of great value to pathologists as well as primary care physicians, breast surgeons, and oncologists for understanding breast pathology and its implications for management.

This reference features comprehensive, practical guidance on the pathological aspects of breast disease. With a multidisciplinary approach, it examines traditional histopathological characteristics while also emphasizing the latest advances in molecular biology and genetics, and the role of newer techniques such as immunocytochemistry. Abundantly illustrated! Limited to the United States, Central America, South America, and the Caribbean.