TY - CHAP M1 - Book, Section TI - Total Mastectomy and Modified Radical Mastectomy A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. PY - 2022 T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - Over the past 20 years, multiple international clinical studies have shown equivalent survival between patients treated with mastectomy and appropriately selected patients treated with breast-conserving surgery and adjuvant radiation, hormonal therapy, and/or chemotherapy. Accordingly, breast-conserving surgery has become the dominant mode of treatment, with mastectomy becoming the alternate choice in certain circumstances. A residual large cancer after neoadjuvant therapy (especially in a small breast), multicentric cancers, and patient preference or concerns about the complications of radiation therapy are the principal indications for the operation. Prior to surgery, the opposite breast should be evaluated by physical examination and mammography. The role of magnetic resonance imaging to screen the contralateral breast is still an area of controversy. Appropriate blood tests and imaging scans and mammographic studies are done in a search for potential metastases to the lung, liver, or bone. The standard preadmission physical examination and laboratory evaluations are done in an ambulatory setting because most patients are admitted to the hospital on the day of operation. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187823701 ER -