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Surgical Approach in Invasive Breast Cancer

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Breast Cancer
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Abstract

Surgery is an established part of the management of primary breast cancer. Surgical management of breast cancer patients has evolved significantly over the last several decades. With the arrival of sentinel lymph node biopsy, surgical practice for axillary staging in patients with early stage breast cancer has gradually become less invasive, and formal axillary lymph node dissection has been confined to selected patients. Over the last two decades, evidence from randomized clinical trials has enabled the de-escalation of breast cancer surgery in the management of early-stage breast cancer. Staging and treatment of the axilla constitute a key component in determining initial surgical planning and therapeutic strategies in the treatment of early breast cancer. This chapter provides an updated review of the history and evolution of practices and of current practices for patients with breast cancer, with particular attention paid to surgical recommendations.

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References

  1. Fourquet A, Campana F, Zafrani B, Mosseri V, Vielh P, Durand JC. Prognostic factors of breast recurrence in the conservative management of early breast cancer: a 25-year follow-up. Int J Radiat Oncol Biol Phys. 1989;17:719–25.

    Article  CAS  Google Scholar 

  2. Komoike Y, Akiyama F, Iino Y, Ikeda T, Akashi-Tanaka S, et al. Ipsilateral breast tumor recurrence (IBTR) after breast-conserving treatment for early breast cancer: risk factors and impact on distant metastases. Cancer. 2006;106:35–41.

    Article  Google Scholar 

  3. Pierce LJ, Griffith KA, Buys S, Gaffney DK, Moran MS, Haffty BG, et al. Outcomes following breast conservation versus mastectomy in BRCA1/2 carriers with early-stage breast cancer [abstract]. J Clin Oncol. 2008;26(Suppl 15):536.

    Article  Google Scholar 

  4. Zhou P, Gautam S, Recht A. Factors affecting outcome for young women with early stage invasive breast cancer treated with breast-conserving therapy. Breast Cancer Res Treat. 2007;101:51–7.

    Article  CAS  Google Scholar 

  5. Golshan M, Miron A, Nixon AJ, Garber JE, Cash EP, Iglehart JD, et al. The prevalence of germline BRCA1 and BRCA2 mutations in young women with breast cancer undergoing breast-conservation therapy. Am J Surg. 2006;192:58–62.

    Article  CAS  Google Scholar 

  6. Kroman N, Holtveg H, Wohlfahrt J, Jensen MB, Mouridsen HT, Blichert-Toft M, et al. Effect of breast-conserving therapy versus radical mastectomy on prognosis for young women with breast carcinoma. Cancer. 2004;100:688–93.

    Article  Google Scholar 

  7. Cruz MR, Prestes JC, Gimenes DL, Fanelli MF. Fertility preservation in women with breast cancer undergoing adjuvant chemotherapy: a systematic review. Fertil Steril. 2010;94:138–43.

    Article  Google Scholar 

  8. Dunn L, Fox KR. Techniques for fertility preservation in patients with breast cancer. Curr Opin Obstet Gynecol. 2009;21:68–73.

    Article  Google Scholar 

  9. Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36(19):1994–2001.

    Article  Google Scholar 

  10. Redig AJ, Brannigan R, Stryker SJ, Woodruff TK, Jeruss JS. Incorporating fertility preservation into the care of young oncology patients. Cancer. 2011;117:4–10.

    Article  Google Scholar 

  11. Lee S, Ozkavukcu S, Heytens E, Moy F, Oktay K. Value of early referral to fertility preservation in young women with breast cancer. J Clin Oncol. 2010;28:4683–6.

    Article  Google Scholar 

  12. Arriagada R, Le MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. J Clin Oncol. 1996;14:1558–64.

    Article  CAS  Google Scholar 

  13. Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106.

    Article  CAS  Google Scholar 

  14. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.

    Article  Google Scholar 

  15. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.

    Article  Google Scholar 

  16. National Breast Cencer Centre. Clinical practice guidelines for the management of early breast cancer. 2nd ed. Camperdown: National Health and Medical Research Council (NHMRC); 2001.

    Google Scholar 

  17. Recht A. Contralateral prophylactic mastectomy: caveat emptor. J Clin Oncol. 2009;27:1347–9.

    Article  Google Scholar 

  18. Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2017;35(5):561–4.

    Article  Google Scholar 

  19. Bass SS, Lyman GH, McCann CR, Ku NN, Berman C, Durand K, et al. Lymphatic mapping and sentinel lymph node biopsy. Breast J. 1999;5:288–95.

    Article  Google Scholar 

  20. Cox CE, Nguyen K, Gray RJ, Salud C, Ku NN, Dupont E, et al. Importance of lymphatic mapping in ductal carcinoma in situ (DCIS): why map DCIS? Am Surg. 2001;67:513–9.

    CAS  PubMed  Google Scholar 

  21. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al. The sentinel node in breast cancer—a multicenter validation study. N Engl J Med. 1998;339:941–6.

    Article  CAS  Google Scholar 

  22. Krag DN, Anderson SJ, Julian TB, Brown AM, Harlow SP, Costantino JP, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol. 2010;11:927–33.

    Article  Google Scholar 

  23. Kuehn T, Vogl FD, Helms G, Pueckler SV, Schirrmeister H, Strueber R, et al. Sentinel-node biopsy for axillary staging in breast cancer: results from a large prospective German multi-institutional trial. Eur J Surg Oncol. 2004;30:252–9.

    Article  CAS  Google Scholar 

  24. Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546–53.

    Article  Google Scholar 

  25. Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial. J Natl Cancer Inst. 2006;98:599–609.

    Article  Google Scholar 

  26. Cox CE, Salud CJ, Cantor A, Bass SS, Peltz ES, Ebert MD, et al. Learning curves for breast cancer sentinel lymph node mapping based on surgical volume analysis. J Am Coll Surg. 2001;193:593–600.

    Article  CAS  Google Scholar 

  27. Dupont E, Cox C, Shivers S, Salud C, Nguyen K, Cantor A, et al. Learning curves and breast cancer lymphatic mapping: institutional volume index. J Surg Res. 2001;97:92–6.

    Article  CAS  Google Scholar 

  28. Giuliano AE, Hawes D, Ballman KV, Whitworth PW, Blumencranz PW, Reintgen DS, et al. Association of occult metastases in sentinel lymph nodes and bone marrow with survival among women with early-stage invasive breast cancer. JAMA. 2011;306:385–93.

    Article  CAS  Google Scholar 

  29. Ozmen V, Karanlik H, Cabioglu N, Igci A, Kecer M, Asoglu O, et al. Factors predicting the sentinel and non-sentinel lymph node metastases in breast cancer. Breast Cancer Res Treat. 2006;95(1):1–6.

    Article  CAS  Google Scholar 

  30. Houvenaeghel G, Nos C, Giard S, Mignotte H, Esterni B, Jacquemier J, et al. A nomogram predictive of non-sentinel lymph node involvement in breast cancer patients with a sentinel lymph node micrometastasis. Eur J Surg Oncol. 2009;35:690–5.

    Article  CAS  Google Scholar 

  31. Katz A, Smith BL, Golshan M, Niemierko A, Kobayashi W, Raad RA, et al. Nomogram for the prediction of having four or more involved nodes for sentinel lymph node-positive breast cancer. J Clin Oncol. 2008;26:2093–8.

    Article  Google Scholar 

  32. Scow JS, Degnim AC, Hoskin TL, Reynolds C, Boughey JC. Assessment of the performance of the Stanford online calculator for the prediction of nonsentinel lymph node metastasis in sentinel lymph node-positive breast cancer patients. Cancer. 2009;115:4064–70.

    Article  Google Scholar 

  33. van la Parra RFD, Ernst MF, Bevilacqua JLB, Mol SJ, Van Zee KJ, Broekman JM, et al. Validation of a nomogram to predict the risk of nonsentinel lymph node metastases in breast cancer patients with a positive sentinel node biopsy: validation of the MSKCC breast nomogram. Ann Surg Oncol. 2009;16:1128–35.

    Article  Google Scholar 

  34. Werkoff G, Lambaudie E, Fondrinier E, Levêque J, Marchal F, Uzan M, et al. Prospective multicenter comparison of models to predict four or more involved axillary lymph nodes in patients with breast cancer with one to three metastatic sentinel lymph nodes. J Clin Oncol. 2009;27:5707–12.

    Article  Google Scholar 

  35. Giuliano AE, Ballman KV, McCall L, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOGZ0011 (Alliance) randomized clinical trial. JAMA. 2017;318(10):918–26.

    Article  Google Scholar 

  36. Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol. 2013;14:297–305.

    Article  Google Scholar 

  37. Axelsson CK, Mouridsen HT, Zedeler K. Axillary dissection of level I and II lymph nodes is important in breast cancer classification. The Danish Breast Cancer Cooperative Group (DBCG). Eur J Cancer. 1992;28A:1415–8.

    Article  CAS  Google Scholar 

  38. Kiricuta CI, Tausch J. A mathematical model of axillary lymph node involvement based on 1446 complete axillary dissections in patients with breast carcinoma. Cancer. 1992;69:2496–501.

    Article  CAS  Google Scholar 

  39. Fisher B, Redmond C, Fisher ER, Bauer M, Wolmark N, Wickerham DL, et al. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med. 1985;312:674–81.

    Article  CAS  Google Scholar 

  40. Alkuwari E, Auger M. Accuracy of fine-needle aspiration cytology of axillary lymph nodes in breast cancer patients: a study of 115 cases with cytologic-histologic correlation. Cancer. 2008;114:89–93.

    Article  Google Scholar 

  41. Classe JM, Bordes V, Campion L, Mignotte H, Dravet F, Leveque J, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy for advanced breast cancer: results of Ganglion Sentinelle et Chimiotherapie Neoadjuvante, a French prospective multicentric study. J Clin Oncol. 2009;27:726–32.

    Article  Google Scholar 

  42. Hunt KK, Yi M, Mittendorf EA, Guerrero C, Babiera GV, Bedrosian I, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy is accurate and reduces the need for axillary dissection in breast cancer patients. Ann Surg. 2009;250:558.

    PubMed  Google Scholar 

  43. Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, et al. Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol. 2013;14:609–18.

    Article  Google Scholar 

  44. Boughey JC, Suman VJ, Mittendorf EA, Ahrendt GM, Wilke LG, Taback B, et al. Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial. JAMA. 2013;310:1455–61.

    Article  CAS  Google Scholar 

  45. Fisher B, Bryant J, Wolmark N, Mamounas E, Brown A, Fisher ER, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol. 1998;16:2672–85.

    Article  CAS  Google Scholar 

  46. Bear HD, Anderson S, Smith RE, Geyer CE Jr, Mamounas EP, Fisher B, et al. Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2006;24:2019–27.

    Article  CAS  Google Scholar 

  47. Hudis C, Modi S. Preoperative chemotherapy for breast cancer: miracle or mirage? JAMA. 2007;298:2665–7.

    Article  CAS  Google Scholar 

  48. Dawood S, Cristofanilli M. What progress have we made in managing inflammatory breast cancer? Oncology. 2007;21:673–9.

    PubMed  Google Scholar 

  49. Kell MR, Morrow M. Surgical aspects of inflammatory breast cancer. Breast Dis. 2005;22:67–73.

    Article  Google Scholar 

  50. Stearns V, Ewing CA, Slack R, Penannen MF, Hayes DF, Tsangaris TN. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer. Ann Surg Oncol. 2002;9:235–42.

    Article  Google Scholar 

  51. Motwani SB, Strom EA, Schechter NR, Butler CE, Lee GK, Langstein HN, et al. The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys. 2006;66:76–82.

    Article  Google Scholar 

  52. Ahmed S, Snelling A, Bains M, Whitworth IH. Breast reconstruction. BMJ. 2005;330:943–8.

    Article  CAS  Google Scholar 

  53. Edlich RF, Winters KL, Faulkner BC, Bill TJ, Lin KY. Advances in breast reconstruction after mastectomy. J Long-Term Eff Med Implants. 2005;15:197–207.

    Article  Google Scholar 

  54. Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, et al. Patient-reported outcomes 1 year after immediate breastreconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol. 2017;35(22):2499–506.

    Article  Google Scholar 

  55. Garcia-Etienne CA, Cody Iii HS, Disa JJ, Cordeiro P, Sacchini V. Nipple-sparing mastectomy: initial experience at the Memorial Sloan-Kettering Cancer Center and a comprehensive review of literature. Breast J. 2009;15:440–9.

    Article  Google Scholar 

  56. Petit JY, Veronesi U, Orecchia R, Rey P, Martella S, Didier F, et al. Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO). Breast Cancer Res Treat. 2009;117:333–8.

    Article  CAS  Google Scholar 

  57. Yueh JH, Houlihan MJ, Slavin SA, Slavin SA, Lee BT, Pories SE, et al. Nipple-sparing mastectomy: evaluation of patient satisfaction, aesthetic results, and sensation. Ann Plast Surg. 2009;62:586–90.

    Article  CAS  Google Scholar 

  58. Chung AP, Sacchini V. Nipple-sparing mastectomy: where are we now? Surg Oncol. 2008;17:261–6.

    Article  Google Scholar 

  59. Gerber B, Krause A, Dieterich M, Kundt G, Reimer T. The oncological safety of skin sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction: an extended follow-up study. Ann Surg. 2009;249:461–8.

    Article  Google Scholar 

  60. Piper M, Peled AW, Foster RD, Moore DH, Esserman LJ. Total skin-sparing mastectomy: a systematic review of oncologic outcomes and postoperative complications. Ann Plast Surg. 2013;70:435.

    Article  CAS  Google Scholar 

  61. Mallon P, Feron JG, Couturaud B, Fitoussi A, Lemasurier P, Guihard T, et al. The role of nipple-sparing mastectomy in breast cancer: a comprehensive review of the literature. Plast Reconstr Surg. 2013;131:969–84.

    Article  CAS  Google Scholar 

  62. Foster RD, Esserman LJ, Anthony JP, Hwang ES, Do H. Skin-sparing mastectomy and immediate breast reconstruction: a prospective cohort study for the treatment of advanced stages of breast carcinoma. Ann Surg Oncol. 2002;9:462–6.

    Article  Google Scholar 

  63. Downes KJ, Glatt BS, Kanchwala SK, Mick R, Fraker DL, Fox KR, et al. Skin-sparing mastectomy and immediate reconstruction is an acceptable treatment option for patients with high-risk breast carcinoma. Cancer. 2005;103:906–13.

    Article  Google Scholar 

  64. Carlson GW, Styblo TM, Lyles RH, Jones G, Murray DR, Staley CA, et al. The use of skin sparing mastectomy in the treatment of breast cancer: the Emory experience. Surg Oncol. 2003;12:265–9.

    Article  Google Scholar 

  65. Newman LA, Kuerer HM, Hunt KK, Kroll SS, Ames FC, Ross MI, et al. Presentation, treatment, and outcome of local recurrence afterskin-sparing mastectomy and immediate breast reconstruction. Ann Surg Oncol. 1998;5:620–6.

    Article  CAS  Google Scholar 

  66. Medina-Franco H, Vasconez LO, Fix RJ, Heslin MJ, Beenken SW, Bland KI, et al. Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer. Ann Surg. 2002;235:814–9.

    Article  Google Scholar 

  67. Kronowitz SJ, Robb GL. Radiation therapy and breast reconstruction: a critical review of the literature. Plast Reconstr Surg. 2009;124:395–408.

    Article  CAS  Google Scholar 

  68. Tran NV, Chang DW, Gupta A, Kroll SS, Robb GL. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg. 2001;108:78–82.

    Article  CAS  Google Scholar 

  69. Mehta VK, Goffinet D. Postmastectomy radiation therapy after TRAM flap breast reconstruction. Breast J. 2004;10:118–22.

    Article  Google Scholar 

  70. Clough KB, Kaufman GJ, Nos C, Buccimazza I, Sarfati IM. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010;17:1375–91.

    Article  Google Scholar 

  71. Anderson BO, Masetti R, Silverstein MJ. Oncoplastic approaches to partial mastectomy: an overview of volume-displacement techniques. Lancet Oncol. 2005;6:145–57.

    Article  Google Scholar 

  72. Huemer GM, Schrenk P, Moser F, Wagner E, Wayand W. Oncoplastic techniques allow breast-conserving treatment in centrally located breast cancers. Plast Reconstr Surg. 2007;120:390–8.

    Article  CAS  Google Scholar 

  73. Kaur N, Petit J-Y, Rietjens M, Maffini F, Luini A, Gatti G. Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol. 2005;12:539–45.

    Article  Google Scholar 

  74. Weber WP, Soysal SD, El-Tamer M, Sacchini V, Knauer M, Tausch C, et al. First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat. 2017;165(1):139–49.

    Article  Google Scholar 

  75. Hortobagyi GN. Multidisciplinary management of advanced primary and metastatic breast cancer. Cancer. 1994;74:416–23.

    Article  CAS  Google Scholar 

  76. Babiera GV, Rao R, Feng L, Meric-Bernstam F, Kuerer HM, Singletary SE, et al. Effect of primary tumor extirpation in breast cancer patients who present with stage IV disease and an intact primary tumor. Ann Surg Oncol. 2006;13:776–82.

    Article  Google Scholar 

  77. Khan SA, Stewart AK, Morrow M. Does aggressive local therapy improve survival in metastatic breast cancer? Surgery. 2002;132:620–6.

    Article  Google Scholar 

  78. Rao R, Feng L, Kuerer HM, Singletary SE, Bedrosian I, Hunt KK, et al. Timing of surgical intervention for the intact primary in stage IV breast cancer patients. Ann Surg Oncol. 2008;15:1696–702.

    Article  Google Scholar 

  79. Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino AP, et al. Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. J Clin Oncol. 2006;24:2743–9.

    Article  Google Scholar 

  80. Morrow M, Goldstein L. Surgery of the primary tumor in metastatic breast cancer: closing the barn door after the horse has bolted? J Clin Oncol. 2006;24:2694–6.

    Article  Google Scholar 

  81. Olson JA, Marcom PK. Benefit or bias? The role of surgery to remove the primary tumor in patients with metastatic breast cancer. Ann Surg. 2008;247:739–40.

    Article  Google Scholar 

  82. Badwe R, Hawaldar R, Nair N, Nair N, Kaushik R, Siddique S, et al. Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial. Lancet Oncol. 2015;16(13):1380–8.

    Article  Google Scholar 

  83. Soran A, Ozmen V, Ozbas S, Karanlik H, Muslumanoglu M, Igci A, et al. Randomized trial comparing resection of primary tumor with no surgery in stage IV breast cancer at presentation: protocol MF07-01. Ann Surg Oncol. 2018. https://doi.org/10.1245/s10434-018-6494-6.

    Article  Google Scholar 

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Karanlik, H., Igci, A. (2019). Surgical Approach in Invasive Breast Cancer. In: Aydiner, A., Igci, A., Soran, A. (eds) Breast Cancer . Springer, Cham. https://doi.org/10.1007/978-3-319-96947-3_13

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