M.D. ANDERSON SOLID TUMOR ONCOLOGY SERIES Series Editor Raphael E. Pollock, M.D., PH.D. Springer New York Berlin Heidelberg Barcelona Budapest Hong Kong London Milan Paris Singapore Tokyo FORTHCOMING VOLUMES IN THE M.D. ANDERSON SOLID TUMOR ONCOLOGY SERIES Melanoma Edited by JEFFREY E. LEE, M.D. Gastric Cancer Edited by PAUL F. MANSFIELD, M.D. PUBLISHED VOLUMES IN THE M.D. ANDERSON SOLID TUMOR ONCOLOGY SERIES Liver Cancer Edited by STEVEN A. CURLEY, M.D. S. Eva Singletary, M.D. Professor of Surgery Chief, Surgical Breast Section Department of Surgical Oncology The University of Texas MD. Anderson Cancer Center Editor Breast Cancer With 109 Illustrations, 11 in Color , Springer S. Eva Singletary, M.D., FACS Professor of Surgery Chief, Surgical Breast Section Department of Surgical Oncology-Box 106 The University of Texas M. D. Anderson Cancer Center 1515 Holcombe Boulevard Houston, TX 77030, USA Series Editor Raphael E. Pollock, M.D., PH.D. Head, Division of Surgery Professor and Chairman, Department of Surgical Oncology The University of Texas M. D. Anderson Cancer Center 1515 Holcombe Boulevard Houston, TX 77030, USA Library of Congress Cataloging in Publication Data Singletary, S. Eva. Breast cancer / S. Eva Singletary. p. cm.-(MD Anderson solid tumor oncology series) Includes bibliographical references and index. ISBN-13 978-1-4612-7432-2 e-ISBN-13: 978-1-4612-2146-3 DOl 10.1007/978-1-4612-2146-3 1. Breast-Cancer-Treatment. I. Title. II. Series: M.D. Anderson solid tumor oncology series. [DNLM: 1. Breast Neoplasms-therapy. WP 870 S6175b 1998] RC280.B8S535 1998 616.99'44906-dc21 98-4702 Printed on acid-free paper. © 1999 Springer-Verlag New York, Inc. Sotlcover reprint ofthe hardcover 1s t edition 1999 All rights reserved. This work may not be translated or copied in whole or in part without the writ ten permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in con nection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc., in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. While the advice and information in this book are believed to be true and accurate at the date of go ing to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Production coordinated by Matrix Publishing Services and managed by Terry Kornak; manufactur ing supervised by Ja cqui Ashri. Typeset by Matrix Publishing Services, York, PA. 9 8 7 654 3 2 1 ISBN-13: 978-1-4612-7432-2 Springer-Verlag New York Berlin Heidelberg SPIN 10650700 Dedicated to my son, Benjamin Ross Harkrider, whose learning curiosity and perpetual "why" has opened my mind to see the world from a different perspective. Series Preface The field of solid tumor oncology is changing at an astonishing rate. To learn about new developments, generate fresh research perspectives, and then integrate these advancements into clinical practice is a daunting challenge confronting all who work in the oncology arena. The onset and rapid deployment of internet ca pacities worldwide has created a milieau of global and instantaneous informa tion access. The task of staying current is becoming even more challenging, and in some ways, more difficult to accomplish. Against this information pressure backdrop, how can yet more didactic mate rial for the already overburdened oncology physician be justified? Based on the premise that we all must remain in a learning mode if we are to remain relevant, The University of Texas M.D. Anderson Annual of Solid Tumor Oncology is designed to focus on a single disease site in each volume. It is our belief that there is an information "gray zone" that lies between the peer reviewed (and in creasingly electronically available) individual research report and the large com prehensive multi authored textbook. Between these two loci there exists an in formation gap that will be best served by a succinct disease site-focused volume that provides an indepth analysis of current multimodality care for a specific solid tumor system, as well as the areas of basic, translational, and clinical research that will emerge for future clinical application. Each volume in this series is au thored by an academic surgical oncologist of national repute in practice at the Department of Surgical Oncology at the University of Texas M.D. Anderson Cancer Center. Under the leadership of these individuals, outstanding experts throughout the world have been tapped to contribute to this effort. The target audience is physicians who are focusing on solid tumor oncology. However, it is our hope that medical students and physicians-in-training who as pire to a career in solid tumor oncology will also find these volumes to be of value. In this new era, we are now beginning to understand the molecular deter minants driving solid tumor carcinogenesis, proliferation, and dissemination. These molecularly-based insights are moving rapidly into the clinical armamen tarium. This poses a tremendous challenge to those of us who are not yet fully conversant, yet these developments also give confidence that we are about to en ter what will certainly be the most exciting era yet in solid tumor oncology. The vii viii Series Preface tumors afflicting our patients compel us to be our best, as does our own dedica tion to fighting this disease cluster that will surpass cardiovascular illness as a cause of mortality worldwide early in the next millennium. On behalf of my fac ulty colleague authors at the University of Texas M.D. Anderson Cancer Center and our many contributing experts, I would like to thank you for your willing ness to participate with us in this exciting new project. RAPHAEL E. POLLOCK Houston, Texas Contents Series Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. vii Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Xlll 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S. EVA SINGLETARY 2. Stereotactic Core Needle Biopsy of Breast Lesions: Experience at The University of Texas M. D. Anderson Cancer Center . . . . . . . . .. 4 GARY J. WHITMAN AND CAROL B. STELLING 3. Role of Sonography in Patients with Breast Cancer. . . . . . . . . . . . .. 18 BRUNO D. FORNAGE 4. Breast Scintigraphy .................................... 53 EBRAHIM S. DELPASSAND 5. Magnetic Resonance Imaging of the Breast ................... 66 MARC J. FENSTERMACHER, REVATHY B. IYER, AND CAROL B. STELLING 6. Fine-Needle Aspiration versus Core Needle Biopsy for Diagnosis of Nonpalpable and Palpable Breast Lesions. . . . . . . . . . . . . . . . . . . .. 84 NOUR SNEIGE 7. Prognostic Factors for Invasive Breast Cancer ................. 93 A YSEGUL A. SAHIN AND VICENTE VALERO 8. Breast Specimen Evaluation .............................. 120 BONNIE L. KEMP 9. Surgical and Medical Management of In Situ and Early Stage Breast Carcinoma ...................................... 132 MICHAEL P. VEZERIDIS AND KIRBY I. BLAND 10. Prophylactic Mastectomy ................................ 149 FREDERICK C. AMES IX x Contents 11. Current Status of Axillary Node Dissection ................... 155 NORA HANSEN AND MONICA MORROW 12. Role for Lymphatic Mapping and Sentinel Node Biopsy in Management of Early Stage Breast Cancer .................... 171 MERRICK I. Ross AND KELLY K. HUNT 13. Skin-Sparing Mastectomy and Immediate Breast Reconstruction .... 184 MARK A. SCHUSTERMAN AND GIULIO GHERARDINI 14. Breast Conservation after Tumor Downstaging with Induction Chemotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 KELLY K. HUNT AND AMAN U. BUZDAR 15. Postmastectomy Irradiation: Indications and Techniques .......... 208 ERIC A. STROM AND MARSHA D. McNEESE 16. Outpatient Mastectomy .................................. 224 BARRY W. FEIG 17. Surveillance Studies and Long-Term Follow-Up Care ............ 233 ALICE F. JUDKINS AND S. EVA SINGLETARY 18. Hereditary Breast Cancer ................................ 239 BRIAN P. WHOOLEY AND PATRICK I. BORGEN 19. Breast Cancer During Pregnancy ........................... 253 RICHARD L. THERIAULT 20. Paget's Disease of the Nipple-Areola Complex ................ 262 KELLY K. HUNT AND MERRICK I. Ross 21. Breast Sarcoma ....................................... 273 ALEXANDER R. MILLER AND RAPHAEL E. POLLOCK 22. Male Breast Cancer .................................... 284 DAVID J. WINCHESTER 23. Inflammatory Breast Cancer .............................. 294 R. Y. DECLAN FLEMING AND S. EVA SINGLETARY 24. Dose-Intensive Therapy with Autologous Blood Stem Cell or Bone Marrow Transplantation for Treatment of Breast Cancer ...... 306 RICHARD CHAMPLIN Contents xi 25. In Situ Laser Ablation .................................. 321 DAVID S. ROBINSON 26. Cryosurgery .......................................... 332 MICHAEL S. SABEL AND EDGAR D. STAREN 27. Translational Research in Breast Cancer ...................... 345 DIHUA Yu AND MIEN-CHIE HUNG Index .................................................. 357