Recent advances in the surgical care of breast cancer patients

Abstract

A tremendous improvement in every aspect of breast cancer management has occurred in the last two decades. Surgeons, once solely interested in the extipartion of the primary tumor, are now faced with the need to incorporate a great deal of information, and to manage increasingly complex tasks. As a comprehensive assessment of all aspects of breast cancer care is beyond the scope of the present paper, the current review will point out some of these innovations, evidence some controversies, and stress the need for the surgeon to specialize in the various aspects of treatment and to be integrated into the multidisciplinary breast unit team.

Figure 1

A simple and standardized protocol, with slicing at three levels at 100-micron intervals and double staining with both hematoxylin-eosin and immunohistochemistry, that has allowed the pathologists in the authors' group to diagnose additional nodal disease with an increment of nearly two thirds compared with standard, single-section analysis of the lymph nodes stained with hematoxylin-eosin. (Adapted from Fortunato L, Amini M, Costarelli L, et al. A standardized sentinel lymph node enhanced pathology protocol (SEPP) in patients with breast cancer. J Surg Oncol 2007;96[6]:471; with permission.)