The rise in bilateral mastectomies: Evidence, ethics, and physician's role.

This viewpoint reviews double mastectomies' trend, medical evidence and ethical considerations, as well as the role of the physician in counseling the patient. It concludes that physicians should encourage patients to pursue alternative preventive measures, and promote bilateral mastectomies only for high-risk patients for whom the potential benefits of the surgery are sufficient to justify the surgery's increased risks.

Long-term outcomes after breast conservation therapy for early stage breast cancer in a community setting.

We, as a large community practice, retrospectively reviewed our experience in treating early stage breast cancer to determine rates of breast-conserving therapy (BCT), disease outcomes after such treatment, and risk factors for local recurrence. A hospital tumor registry was used to identify breast cancer cases diagnosed between 1987 and 2003. Rates of BCT and radiotherapy were examined using primary treatment data.

Breast-conserving therapy with adjuvant paclitaxel and radiation therapy: feasibility of concurrent treatment.

As commonly used, adjuvant paclitaxel after doxorubicin in high-risk breast cancer patients results in a prolonged delay of the onset of radiation therapy after breast-conserving surgery. Concurrent delivery of breast irradiation with paclitaxel would allow for earlier initiation of radiation. We report on the toxicity of concurrent paclitaxel and breast irradiation after doxorubicin and cyclophosphamide.

Pathologic features associated with nonsentinel lymph node metastases in patients with metastatic breast carcinoma in a sentinel lymph node.

Background: To the authors' knowledge it has not yet been determined which patients with primary breast carcinoma and an axillary sentinel lymph node (SN) metastasis have additional metastases in nonsentinel lymph nodes.

Methods: Pathologic features of the primary breast carcinoma and its SN metastasis were examined in 194 patients and correlated with the tumor status of the non-SNs in the same axillary basin. Two-level cytokeratin immunohistochemistry was applied to the SNs and to non-SNs of cases that were negative by standard hematoxylin and eosin examination.