RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187823701
T1 Total Mastectomy and Modified Radical Mastectomy
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187823701
RD 2024/04/23
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.