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FURTHER READING Amin MB, Edge S, Greene F et al . (eds). AJCC cancer staging manual , 8th edn. Cham, Switzerland: Springer, 2017. Correa C, Harris EE, Leonardi MC et al. Accelerated partial breast irradiation: update of an ASTRO evidence-based consensus state...

Follow-up of operable breast cancer Follow-up after initial therapy routinely includes clinical exam ination every 3 months for 2 years, followed by every 6 months for the next 3 years. Thereafter the follow-up is scheduled yearly . A mammogram is also schedul...

Haematogenous spread 5 At a tumour size of 1–2 /uni00A0 mm (10 cells) neoangiogenesis occurs. The onset of angiogenesis ushers in rapid growth, invasion and metastatic potential. Haematogenous metastasis occurs to the skeletal system (in order of frequency:...

Hereditary and familial breast cancer Hereditary breast cancer (HBC) runs in families, a ff ect - ing several close relatives, and is associated with an identifiable genetic mutation. Familial breast cancer (FBC) a ff ects several members of a family but is not...

INVESTIGATIONS FOR BREAST SYMPTOMS The assessment of women presenting with symptomatic breast disease is carried out in a systematic manner. -

Injuries of the breast Haematoma Haematoma, particularly a resolving haematoma, gives rise to a lump that, in the absence of overlying bruising, is di ffi cult to diagnose correctly unless it is biopsied. Traumatic fat necrosis may be acute or chronic and usual...

Introduction No content extracted automatically.

Learning objectives To understand: Appropriate investigation of breast disease • Aberrations of Normal Development and Involution (ANDI) • concept and management of benign breast disease

Lymphatic metastasis This occurs mainly to axillary lymph nodes. Tumours from the inner half of the breast may also spread to the internal mammary nodes. Involvement of the contralateral lymph nodes in the absence of a contralateral primary represents meta...

Macromastia Macromastia is a benign disorder characterised by massive enlargement of one or both breasts disproportionate to the body habitus. The aetiology of this condition is multifactorial: it is usually idiopathic or associated with obesity , the presen...

Magnetic resonance imaging MRI of the breast ( Figure 58.9 ) is useful in a number of settings: - /uni25CF women with dense breasts or discordant or equivocal find - ings on mammogram/ultrasonography; /uni25CF to distinguish scar from recurrence in women who h...

Mammography Mammography in two planes and ultrasonography are the first line investigations for imaging the breast. Magnetic resonance imaging (MRI) is a valuable adjunctive diagnostic tool because of its high sensitivity for breast pathology . Mammography is ...

Management of local recurrence The local recurrence should be biopsied as a change in receptor status may occur and influence further therapy . Whole-body MRI or PET-CT scan should be performed to detect metas - tasis. Systemic chemotherapy should be followed ...

Mastalgia Approximately 50–70% of women attending any breast clinic present with mastalgia (synonym: mastodynia or mazodynia). True mastalgia (arising from breast tissue) is classified into cyclical and non-cyclical types. Cyclical mastalgia The pain usually s...

Mastitis of infants Mastitis of infants may occur in both boys and girls. It is uncommon and is predominantly caused by Staphylococcus aureus .

Metastatic carcinoma of the breast (stage IV) Treatment of metastatic cancer is aimed at palliating symp toms, improving quality of life, preventing potential disabling complications and attempting to prolong life. Endocrine therapy for hormone receptor-posi...

Needle biopsy Tissue for histological examination can be obtained under local anaesthesia using a large-diameter core needle biopsy device (14G for breast tissue and 18G for axillary nodes) ( Figure 58.11 ). The core needle biopsy should always be taken under ...

Nipple inversion and retraction At birth the mammary glands in boys and girls are similar. At around 11–12 years of age, in girls the breast begins to grow . The onset of its growth is called ‘the telarche’ (1 year before menarche). Initially uniform growth ...