Skip to main content

Tailored Surgery: Limited Breast and Lymph Node Surgery

  • Chapter
  • First Online:
Breast Cancer, a Heterogeneous Disease Entity
  • 683 Accesses

Abstract

Oncological surgery of the breast has undergone changes from several aspects in the past 20 years. The primary reason has been the introduction of a biological approach, cancer screening, development of the surgical technique and the daily use of quality assurance principles. We are again witnessing a paradigm change, the essence of which is that maximal radical treatment is being replaced by minimal but sufficient surgical intervention. However, surgery remains determinant in the treatment of breast cancer.

Quod medicamentum non sanat: ferrum sanat, quod ferrum non sanat: ignis sanat, quod ignis non sanat: nihil sanat

Hippocrates

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Albertini JJ, Lyman GH, Cox C et al (1996) Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 276:1818–1822

    Article  PubMed  CAS  Google Scholar 

  • Alexander HR, Candela FC, Dershaw DD et al (1990) Needle-localized mammograophic lesions. Results and evolving treatment strategy. Arch Surg 125:1441–1445

    Article  PubMed  CAS  Google Scholar 

  • Antonini N, Jones H, Horiot JC et al (2007) Effect of age and radiation dose on local control after breast conserving treatment: EORTC trial 22881–10882. Radiother Oncol 82:265–271

    Article  PubMed  Google Scholar 

  • Barros AC, Barros MA, Andrade FE et al (2007) Combined radioguided nonpalpable lesion localization and sentinel lymph node biopsy for early breast carcinoma. Ann Surg Oncol 14:1472–1477

    Article  PubMed  Google Scholar 

  • Borgstein PJ, Meijer S, Pijpers RJ et al (2000) Functional lymphatic anatomy for sentinel node biopsy in breast cancer: echoes from the past and the periareolar blue method. Ann Surg 232:81–89

    Article  PubMed  CAS  Google Scholar 

  • Boughey JC, Gonzalez RJ, Bonner E et al (2007) Current treatment and clinical trial developments for ductal carcinoma in situ of the breast. Oncologist 12:1276–1278

    Article  PubMed  CAS  Google Scholar 

  • Brogi E, Torres-Matundan E, Tan LK et al (2005) The results of frozen section, touch preparation, and cytological smear are comparable for intraoperative examination of sentinel lymph nodes: a study in 133 breast cancer patients. Ann Surg Oncol 12:173–180

    Article  PubMed  Google Scholar 

  • Burbank F, Parker SH (1998) Methods for evaluating the quality of an image-guided breast biopsy program. Seminars in Breast Disease 1:71–83

    Google Scholar 

  • Cabanas R (1977) An approach for the treatment of penile carcinoma. Cancer 39:456–466

    Article  PubMed  CAS  Google Scholar 

  • Camp R, Feezor R, Kasraeian A et al (2005) Sentinel lymph node biopsy for ductal carcinoma in situ: an evolving approach at the University of Florida. Breast J 11:394–397

    Article  PubMed  Google Scholar 

  • Clarke M, Collins R, Darby S et al (2005) 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 366:2087–2106

    PubMed  CAS  Google Scholar 

  • De Cicco C, Trifiro G, Intra M et al (2004) Optimised nuclear medicine method for tumour marking and sentinel node detection in occult primary breast lesions. Eur J Nucl Med Mol Imaging 31:349–354

    Article  PubMed  CAS  Google Scholar 

  • DiBiase SJ, Komarnicky LT, Heron DE et al (2002) Influence of radiation dose on positive surgical margins in women undergoing breast conservation therapy. Int J Radiat Oncol Biol Phys 3:680–686

    Article  Google Scholar 

  • Estourgie SH, Tanis PJ, Nieweg OE et al (2003) Should the hunt for internal mammary chain sentinel nodes begin? An evaluation of 150 breast cancer patients. Ann Surg Oncol 10:935–941

    Article  PubMed  Google Scholar 

  • Farkas EA, Stolier AJ, Teng SC, et al. (2004) An argument against routine sentinel node mapping for DCIS. Am Surg. Jan;70:13–17; discussion 17–18

    PubMed  CAS  Google Scholar 

  • Faverly DRG, Hendricks JHCL, Holland R (2001). Breast carcinoma of limited extent. Frequency, radiologic—pathologic characteristics, and surgical margin requirements. Cancer 91:647–659

    Article  PubMed  CAS  Google Scholar 

  • Feggi L, Basaglia E, Corcione S et al (2001) An original approach in the diagnosis of early breast cancer: use of the same radiopharmaceutical for both non-palpable lesions and sentinel node localization. Eur J Nucl Med 28:1589–1596

    Article  PubMed  CAS  Google Scholar 

  • Fisher B, Dignam J, Wolmark N et al (1998) Lumpectomy and radiation therapy for the treatment of intraductal breast cancer. Findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol 16:441–452

    CAS  Google Scholar 

  • Fisher B, Jeong JH, Dignam J et al (2001) Findings from recent National Surgical Adjuvant Breast and Bowel Project adjuvant studies in stage I breast cancer. J Natl Cancer Inst Monogr 30:62–66

    Article  PubMed  Google Scholar 

  • Fisher ER, Costantino J, Fisher B et al (1995) Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP) protocol B-17. Cancer 75:1310–1319

    Article  PubMed  CAS  Google Scholar 

  • Fisher ER, Dignam J, Tan-Chiu E et al (1999) Pathologic findings from the National Surgical Adjuvant Breast Project (NSABP): eight-year update of protocol B-17. Cancer 86:429–438

    Article  PubMed  CAS  Google Scholar 

  • Frank HA, Hall FM, Steer ML (1976) Preoperative localization of nonpalpable breast lesions demontrated by mammography. N Engl J Med 295:259–260

    Article  PubMed  CAS  Google Scholar 

  • Freedman G, Fowble B, Hanlon A et al (1999) Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy. Int J Radiat Oncol Biol Phys 44:1005–1015

    Article  PubMed  CAS  Google Scholar 

  • Gage I, Schnitt SJ, Nixon AJ et al (1996) Pathologic margin involvement and the risk of recurrence in patients treated with breast-conserving therapy. Cancer 9:1921–1928

    Article  Google Scholar 

  • Gajdos C, Levy M, Herman Z et al (1999) Complete removal of nonpalpable breast malignancies with a stereotactic percutaneous vacuum-assisted biopsy instrument. J Am Coll Surg 189:237–240

    Article  PubMed  CAS  Google Scholar 

  • Gennari R, Galimberti V, De Cicco C et al (2000) Use of technetium-99m-label colloid albumin for preoperative and intraoperative localization of nonpalpable breast lesions. J Am Coll Surg 190:692–699

    Article  PubMed  CAS  Google Scholar 

  • Gentilini O, Botteri E, Rotmensz N et al (2009) Conservative surgery in patients with multifocal/multicentric breast cancer. Breast Cancer Res Treat 113:577–583

    Article  PubMed  Google Scholar 

  • Giuliano AE, Kirgan DM, Guenther JM et al (1994) Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 200:391–398

    Article  Google Scholar 

  • Gould EA, Winship T, Philbin PH et al (1960) Observations on a “sentinel node” in cancer of the parotid. Cancer 13:77–78

    Article  PubMed  CAS  Google Scholar 

  • Goyal A, Newcombe RG, Mansel RE (2005a) Clinical relevance of internal mammary node drainage in sentinel node biopsy for breast cancer. J Clin Oncol 23(16S):519

    Google Scholar 

  • Goyal A, Newcombe RG, Mansel RE et al (2005b) Role of routine preoperative lymphoscintigraphy in sentinel node biopsy for breast cancer. Eur J Cancer 41:238–243

    Article  Google Scholar 

  • Goyal A, Newcombe RG, Chhabra A et al (2006) Factors affecting failed localization and false-negative rates of sentinel node biopsy in breast cancer—results of the ALMANAC validation phase. Breast Cancer Res Treat 99:203–208

    Article  PubMed  Google Scholar 

  • Grant RN, Tabah EJ, Adair FE (1953) The surgical significance of the subareolar symph plexus in cancer of the breast. Surgery 33:71–78

    PubMed  CAS  Google Scholar 

  • Gray RJ, Giuliano R, Dauway EL et al (2001) Radioguidance for nonpalpable primary lesions and sentinel lymph node(s). Am J Surg 182:404–406

    Article  PubMed  CAS  Google Scholar 

  • Gray RJ, Pockaj BA, Karstaedt PJ et al (2004) Radioactive seed localization of nonpalpable breast lesions is better than wire localization. Am J Surg 188:337–380

    Google Scholar 

  • Gur AS, Unal B, Johnson R et al (2009) Predictive probability of four different breast cancer nomograms for nonsentinel axillary lymph node metastasis in positive sentinel node biopsy. J Am Coll Surg 208:229–235

    Article  PubMed  Google Scholar 

  • Haigh PI, Hansen NM, Qi K et al (2000) Biopsy method and excision volume do not affect success rate of subsequent sentinel lymph node dissection in breast cancer. Ann Surg Oncol 7:21–27

    Article  PubMed  CAS  Google Scholar 

  • Ikeda T, Akiyama F, Hiraoka M et al (1999) Surgical margin status as a cause of local failure after breast conserving therapy. Breast Cancer 6:93–97

    Article  PubMed  Google Scholar 

  • Intra M, Zurrida S, Maffini F (2003) Sentinel lymph node metastasis in microinvasive breast cancer. Ann Surg Oncol 10:1160–1165

    Article  PubMed  Google Scholar 

  • Jackman RJ, Marzoni FA Jr (1997) Needle-localized breast biopsy: why do we fail? Radiology 204:677–684

    PubMed  CAS  Google Scholar 

  • Johnston EI, Beach RA, Waldrop SM et al (2006) Rapid intraoperative immunohistochemical evaluation of sentinel lymph nodes for metastatic breast carcinoma. Appl Immunohistochem Mol Morphol 14:57–62

    Article  PubMed  Google Scholar 

  • Katz A, Gage I, Evans S et al (2006) Sentinel lymph node positivity of patients with ductal carcinoma in situ or microinvasive breast cancer. Am J Surg 191:761–766

    Article  PubMed  Google Scholar 

  • Kelly TA, Kim JA, Patrick R et al (2003) Axillary lymph node metastases in patient with a final diagnosis of ductal carcinoma in situ. Am J Surg 186:368–370

    Article  PubMed  Google Scholar 

  • Kim T, Giuliano AE, Lyman GH (2006) Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a metaanalysis. Cancer 106:4–16

    Article  PubMed  Google Scholar 

  • Klimberg VS, Rubio IT, Henry R et al (1999) Subareolar versus peritumoral injection for location of the sentinel lymph node. Ann Surg 229:860–864

    Article  PubMed  CAS  Google Scholar 

  • Knauer M, Konstantiniuk P, Haid A et al (2006) Multicentric breast cancer: a new indication for sentinel node biopsy—a multiinstitutional validation study. J Clin Oncol 24:3374–3380

    Article  PubMed  Google Scholar 

  • Kocsis L, Svebis M, Cserni G et al (2004) Use and limitations of a nomogram predicting the likelihood of non-sentinel node involvement after a positive sentinel node biopsy in breast cancer patients. Am Surg 70:1019–1024

    PubMed  Google Scholar 

  • Kontos M, Felekouras E, Fentiman IS (2008) Radiofrequency ablation in the treatment of primary breast cancer: no surgical redundancies yet. Int J Clin Pract 62:816–820

    Article  PubMed  CAS  Google Scholar 

  • Kopans DB, Lindfors KK, McCarthy KA et al (1985) Spring hookwire breast lesion localizer: use with rigid-cempression mammographic systems. Radiology 157:537–538

    PubMed  CAS  Google Scholar 

  • Krag DN, Anderson SJ, Julian TB et al (2007) Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial. Lancet Oncol 8:881–888

    Article  PubMed  CAS  Google Scholar 

  • Krag DN, Weaver DL, Alex JC et al (1993) Surgical resection and radiolocalization of sentinel lymph node in breast cancer using a gamma probe. Surg Oncol 2:335–340

    Article  PubMed  CAS  Google Scholar 

  • Kronowitz SJ, Kuerer HM, Buchholz TA, Valero V, Hunt KK (2008) A management algorithm and practical oncoplastic surgical techniques for repairing partial mastectomy defects. Review Plast Reconstr. Surg 122:1631–1647

    CAS  Google Scholar 

  • Kurtz JM, Jacquemier J, Amatric R et al (1990) Breast conserving therapy for macroscopically multiple cancer. Ann Surg 212:38–44

    Article  PubMed  CAS  Google Scholar 

  • Leidenius M, Salmenkivi K, von Smitten K et al (2006) Tumour-positive sentinel node findings in patients with ductal carcinoma in situ. J Surg Oncol 94:380–384

    Article  PubMed  CAS  Google Scholar 

  • Leidenius MH, Vironen JH, von Smitten KA et al (2009) The outcome of sentinel node biopsy in breast cancer patients with preoperative surgical biopsy. J Surg Oncol 99:420–423

    Article  PubMed  Google Scholar 

  • Liberman L, Dershaw DD, Rosen PP et al (1998) Percutaneous removal of malignant mammographic lesions at stereotactic vacuum-assisted biopsy. Radiology 206:711–715

    PubMed  CAS  Google Scholar 

  • Luini A, Zurrida S, Galimberti V et al (1998) Radioguided surgery of occult breast lesions. Eur J Cancer 34:204–205

    Article  PubMed  CAS  Google Scholar 

  • Luini A, Zurrida S, Paganelli G et al (1999) Comparison of radioguided excision with wire localization of occult breast lesions. Br J Surg 86:522–525

    Article  PubMed  CAS  Google Scholar 

  • Luini A, Galimberti V, Gatti G et al (2005) The sentinel node biopsy after previous breast surgery: preliminary results on 543 patients treated at the European institute of oncology. Breast Cancer Res Treat 89:159–163

    Article  PubMed  Google Scholar 

  • Luini A, Rososchansky J, Gatti G et al (2009) The surgical margin status after breast-conserving surgery: discussion of an open issue. Breast Cancer Res Treat 113:397–402

    Article  PubMed  Google Scholar 

  • Mabry H, Giuliano AE, Silverstein MJ et al (2006) What is the value of axillary dissection or sentinel node biopsy in patients with ductal carcinoma ins situ? Am J Surg 192:455–457

    Article  PubMed  Google Scholar 

  • Mansel RE, Fallowfield L, Kissin M et al (2006) Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC trial. J Natl Cancer Inst 98:599–609

    Article  PubMed  Google Scholar 

  • Masakuni N (2003) Minimally invasive surgery for small breast cancer. J Surg Oncol 84:94–101

    Article  Google Scholar 

  • McMasters KM, Wong SL, Martin RC et al (2001) Dermal injection of radioactive colloid is superior to peritumoral injection for breast cancer sentinel lymph node biopsy: results of a multiinstitutional study. Ann Surg 233:676–687

    Article  PubMed  CAS  Google Scholar 

  • Medina-Franco H, Abarca-Pérez L, García-Alvarez MN et al (2008) Radioguided Occult Lesion Localization (ROLL) versus wire-guided lumpectomy for non-palpable breast lesions: a randomized prospective evaluation. J Surg Oncol 97:108–111

    Article  PubMed  Google Scholar 

  • Mirza NQ, Vlastos G, Meric F et al (2002) Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy. Ann Surg Oncol 9:256–265

    Article  PubMed  Google Scholar 

  • Monti S, Galimberti V, Trifiro G et al (2007) Occult breast lesion localization plus sentinel node biopsy (SNOLL): experience with 959 patients at the European institute of oncology. Ann Surg Oncol 14:2928–2931

    Article  PubMed  Google Scholar 

  • Moreno M, Wiltgen JE, Bodanese B et al (2008) Radioguided breast surgery for occult lesion localization—correlation between two methods. J Exp Clin Cancer Res 27:29

    Article  PubMed  CAS  Google Scholar 

  • Nadeem R, Chagla LS, Harris O et al (2005) Occult breast lesions: a comparison between Radioguided Occult Lesion Localisation (ROLL) vs. Wire-Guided Lumpectomy (WGL). Breast 14:283–289

    Article  PubMed  CAS  Google Scholar 

  • Noguchi M (2009) Radiofrequency ablation therapy for small breast cancer. Semin Ultrasound CT MR 30:105–112

    Article  PubMed  Google Scholar 

  • Ohtake T, Abe R, Kimijima I et al (1995) Intraductal extension of primary invasive breast carcinoma treated by breast-conservative surgery. Computer graphic three-dimensional reconstruction of the mammary duct-lobular systems. Cancer 76:32–45

    Article  PubMed  CAS  Google Scholar 

  • Pálka I, Kelemen G, Ormándi K et al (2008) Tumor characteristics in screen-detected and symptomatic breast cancers. Pathol Oncol Res 14:161–167

    Article  PubMed  Google Scholar 

  • Park CC, Mitsumori M, Nixon A et al (2000) Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence. J Clin Oncol 8:1668–1675

    Google Scholar 

  • Pittinger TP, Maronian NC, Poulter CA et al (1994) Importance of margin status in outcome of breast-conserving surgery for carcinoma. Surgery 116:605–609

    PubMed  CAS  Google Scholar 

  • Pleijhuis RG, Graafland M, de Vries J et al (2009) Obtaining adequate surgical margins in breast-conserving therapy for patients with early-stage breast cancer: current modalities and future directions. Ann Surg Oncol 16:2717–2730

    Article  PubMed  Google Scholar 

  • Port ER, Fey J, Gemignani ML et al (2002) Reoperative sentinel lymph node biopsy: a new option for patients with primary or locally recurrent breast carcinoma. J Am Coll Surg 195:167–172

    Article  PubMed  Google Scholar 

  • Port ER, Garcia-Etienne CA, Park J et al (2007) Reoperative sentinel lymph node biopsy: a new frontier in the management of ipsilateral breast tumor recurrence. Ann Surg Oncol 14:2209–2214

    Article  PubMed  Google Scholar 

  • Povoski SP, Neff RL, Mojzisik CM et al (2009) A comprehensive overview of radioguided surgery using gamma detection probe technology. World J Surg Oncol 7:11

    Article  PubMed  Google Scholar 

  • Povoski SP, Olsen JO, Young DC et al (2006) Prospective randomized clinical trial comparing intradermal, intraparenchymal, and subareolar injection routes for sentinel lymph node mapping and biopsy in breast cancer. Ann Surg Oncol 13:1412–1421

    Article  PubMed  Google Scholar 

  • Rampaul RS, Bagnall M, Burrell H et al (2004) Randomized clinical trial comparing radioisotope occult lesion localization and wire-guided excision for biopsy of occult breast lesions. Br J Surg 91:1575–1577

    Article  PubMed  CAS  Google Scholar 

  • Ronka R, Krogerus L, Leppanen E et al (2004) Radio-guided occult lesion localization in patients undergoing breast-conserving surgery and sentinel node biopsy. Am J Surg 187:491–496

    Article  PubMed  Google Scholar 

  • Schrenk P, Wayand W (2001) Sentinel-node biopsy in axillary lymph-node staging for patients with multicentric breast cancer. Lancet 357:122

    Article  PubMed  CAS  Google Scholar 

  • Schwartz GF, Solin LJ, Olivotto IA et al (1999) Consensus conference committee: consensus conference on the treatment of in situ ductal carcinoma of the breast. Cancer 88:946–954

    Article  Google Scholar 

  • Silverstein MJ, Waisman JR, Gamagami P et al (1990) Intraductal carcinoma of the breast (208 cases): clinical factors influencing treatment choice. Cancer 66:102–108

    Article  PubMed  CAS  Google Scholar 

  • Smitt MC, Nowels KW, Zdeblick MJ et al (1995) The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer 76:259–267

    Article  PubMed  CAS  Google Scholar 

  • Solin LJ, Kurtz J, Fourquet A et al (1996) Fifteen-year results of breast-conserving surgery and definitive breast irradiation for the treatment of ductal carcinoma in situ of the breast. J Clin Oncol 14:754–763

    PubMed  CAS  Google Scholar 

  • Spear SL, Hannan CM, Willey SC, Cocilovo C (2009) Nipple-sparing mastectomy. Plast Reconstr Surg 123:1665–1673

    Article  PubMed  CAS  Google Scholar 

  • Takács T, Paszt A, Szentpáli K et al (2009) Importance of sentinel lymph node biopsy in surgical therapy of in situ breast cancer. Pathol Oncol Res 15:329–333

    Article  PubMed  Google Scholar 

  • Tartter PI, Kaplan J, Bleiweiss I et al (2000) Lumpectomy margins, reexcision, and local recurrence of breast cancer. Am J Surg 179:81–85

    Article  PubMed  CAS  Google Scholar 

  • Tew K, Irwig L, Matthews A et al (2005) Meta-analysis of sentinel node imprint cytology in breast cancer. Br J Surg 92:1068–1080

    Article  PubMed  CAS  Google Scholar 

  • Thind CR, Desmond S, Harris O et al (2005) Radio-guided localization of clinically occult breast lesions (ROLL): a DGH experience. Clin Radiol 60:681–686

    Article  PubMed  CAS  Google Scholar 

  • Tousimis E, Van Zee KJ, Fey JV et al (2003) The accuracy of sentinel lymph node biopsy in multicentric and multifocal invasive breast cancers. J Am Coll Surg 197:529–535

    Article  PubMed  Google Scholar 

  • van der Ent FW, Kengen RA, van der Pol HA et al (2001) Halsted revisited: internal mammary sentinel lymph node biopsy in breast cancer. Ann Surg 234:79–84

    Article  PubMed  CAS  Google Scholar 

  • Van Zee KJ, Manasseh D, Bevilacqua J et al (2003) A nomogram for predicting the likelihood of additional nodal metastases in breast cancer patients with a positive sentinel lymph node biopsy. Ann Surg Oncol 10:1140–1151

    Article  PubMed  Google Scholar 

  • Verkooijen HM, Peeter PH, Pijnappel RM et al (2000) Diagnostic accuracy of needle-localized open breast biopsy for impalpable breast disease. Br J Surg 87:344–347

    Article  PubMed  CAS  Google Scholar 

  • Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232

    Article  PubMed  Google Scholar 

  • Veronesi U, Galimberti V, Mariani L et al (2005a) Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection. Eur J Cancer 41:231–237

    Article  PubMed  Google Scholar 

  • Veronesi P, Intra M, Vento AR et al (2005b) Sentinel lymph node biopsy for localised ductal carcinoma in situ? Breast 14:520–522

    Article  PubMed  CAS  Google Scholar 

  • Veronesi U, Marubini E, Mariani L et al (1999) The dissection of internal mammary nodes does not improve the survival of breast cancer patients, 30-year results of a randomised trial. Eur J Cancer 35:1320–1325

    Article  PubMed  CAS  Google Scholar 

  • Viale G, Bosari S, Mazzarol G et al (1999) Intraoperative examination of axillary sentinel lymph nodes in breast carcinoma patients. Cancer 85:2433–2438

    Article  PubMed  CAS  Google Scholar 

  • Vicini FA, Kestin LL, Goldstein NS et al (2001) Relationship between excision volume, margin status, and tumor size with the development of local recurrence in patients with ductal carcinoma in situ treated with breast-conserving therapy. J Surg Oncol 76:245–254

    Article  PubMed  CAS  Google Scholar 

  • Voogd AC, Nielsen M, Peterse JL et al (2001) Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer: pooled results of two large European randomized trials. J Clin Oncol 19:1688–1697

    PubMed  CAS  Google Scholar 

  • Vrieling C, Collette L, Fourquet A et al (2003) Can patient-, treatment- and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in young patients? Eur J Cancer 39:932–944

    Article  PubMed  CAS  Google Scholar 

  • Wallgren A, Bonetti M, Gelber RD et al (2003) Risk factors for locoregional recurrence among breast cancer patients: results from international breast cancer study group trials I through VII. J Clin Oncol 21:1205–1213

    Article  PubMed  CAS  Google Scholar 

  • Wilkie C, White L, Dupont E, Cantor A, Cox CE (2005) An update of sentinel lymph node mapping in patients with ductal carcinoma in situ. Am J Surg 190:563–566

    Article  PubMed  Google Scholar 

  • Wilson LD, Beinfield M, McKhan CF et al (1993) Conservative surgery and radiation in treatment of synchronous ipsilateral breast cancers. Cancer 72:137–142

    Article  PubMed  CAS  Google Scholar 

  • Zavagno G, Carcoforo P, Marconato R et al (2005) Role of axillary sentinel lymph node biopsy in patient with pure ductal carcinoma in situ of the breast. BMC Cancer 5: 28–34

    Article  PubMed  Google Scholar 

  • Zavagno G, Belardinelli V, Marconato R et al (2007) Sentinel lymph node metastasis from mammary ductal carcinoma in situ with microinvasion. Breast 16:146–151

    Article  PubMed  Google Scholar 

  • Zavagno G, De Salvo GL, Scalco G et al (2008) A randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer: results of the Sentinella/GIVOM trial. Ann Surg 247:207–213

    Article  PubMed  Google Scholar 

  • Zgajnar J, Hocevar M, Frkovic-Grazio S et al (2004) Radioguided Occult Lesion Localization (ROLL) of the nonpalpable breast lesions. Neoplasma 51:385–389

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to György Lázár .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media B.V.

About this chapter

Cite this chapter

Lázár, G. (2011). Tailored Surgery: Limited Breast and Lymph Node Surgery. In: Kahán, Z. (eds) Breast Cancer, a Heterogeneous Disease Entity. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0489-3_8

Download citation

Publish with us

Policies and ethics