Frederick M. Dirbas, M.D. Associate Professor of Surgery Breast Disease Management Group Leader Clinical Care Sub-Team Division of Surgical Oncology Department of Surgery Stanford University School of Medicine, Stanford Cancer Center 875 Blake Wilbur Drive, CC2235 Stanford, CA 94025, USA Carol E. H. Scott-Conner, M.D., Ph.D. Department of Surgery University of Iowa Hospitals and Clinic 200 Hawkins Drive, 1516 JCP Iowa City, IA 52242-1086, USA

• Foreword.- Section One-Fundamentals.- Professionalism in the Approach to the Patient.- The Clinical Breast Cancer Team.- The Role of the Specialist Breast Nurse.- Social Work and Breast Cancer Care.- Reducing Medical Malpractice Risk in Breast Cancer Care: A Surgical Perspective.- Career Development for Breast Surgical Oncology.- Successful Management of a Breast Surgery Practice.- Section Two-Biologic Principles.- Normal Morphology, Physiological Changes, and Benign Breast Disease.- The Biology of Breast Cancer.- Section Three-Initial Evaluation of the Patient.- Obtaining a History and Performing the Clinical Breast Examination.- Primer on Ultrasound for the Breast Surgeon.- The Complete Radiology Workup.- Section Four-Common Presenting Complaints and Concerns.- Identification and Management of Women at High Familial Risk for Breast Cancer.- Clinical Management of Breast Pain.- Breast Mass.- Breast Infection.- The Evaluation and Treatment of Nipple Discharge.- Gynecomastia.- The Effects of Menopausal Hormone Therapy on Breast Cancer: Evidence from the Women’s Health Initiative Randomized Placebo-Controlled Trials.- Section Five-Diagnostic Techniques.- Office Diagnostic Procedures.- Image-Guided Breast Biopsy.- Breast Biopsy Techniques.- Mammary Ductoscopy.- Section Six - Breast Cancer Overview.- Assessment Of Extent Of Disease In Primary Breast Cancer.- Breast Cancer Staging: Predicting Outcome and Response to Treatment.- Breast Cancer Treatment Guidelines.- Introduction to Gene Expression Profiling in Breast Cancer.- Clinical Trial Overview and Enrollment.- Psychiatric and Psychological Issues.- Fertility Issues for Newly Diagnosed Women Interested in Child Bearing – Strategies and Options.- Section Seven - Breast Surgery – Management of the Primary Tumor.- Regional Anesthesia for Breast Surgery.- Lumpectomy.- Oncoplastic Techniques for Breast Conservation Surgery.- Ablative Techniques.- Mastectomy.- Nipple and Areola-Sparing Mastectomy.- Integration ofNeoadjuvant Systemic Therapy Into Surgical Practice.- Oncologic Breast Reconstruction: Principles and Practice.- Section Eight - Breast Surgery – Sentinel Node Biopsy and Axillary Dissection.- Sentinel Lymph Node Biopsy—an Overview.- Sentinel Lymph Node Biopsy: Radiotracer Technique at Memorial Sloan-Kettering Cancer Center.- Sentinel Node Biopsy Using Lymphazurin.- The Use of Methylene Blue as a Tracer Agent in Sentinel Lymph Node Biopsy.- Axillary Lymph Node Dissection.- Section Nine - Breast Surgery – Special Issues.- Evaluation and Management of Women Presenting with Breast Symptoms During Pregnancy.- Paget’s Disease Of The Breast.- Male Breast Cancer.- Breast Sarcomas.- Axillary Metastases with Unknown Primary.- Section Ten - Cytology and Pathology.- Breast Cytology.- The Breast Pathology Report.- Risk Lesions of the Breast: Usual Ductal Hyperplasia, Atypical Ductal Hyperplasia, Lobular Neoplasia, and the Spectrum of Columnar Cell Alterations.- Duct Carcinoma In Situ – a Gordian Knot Untied.- Pathology: Invasive Carcinoma.- Interpreting Breast Pathology in the Setting of Neoadjuvant Chemotherapy.- Pathology of Sentinel Lymph Nodes and Axillary Nodes.- Selected Fibroepithelial, Mesenchymal and Hematolymphoid Tumors of the Breast.- Banking tissue specimens for research.- Section Eleven - Systemic Therapy for Breast Cancer.- Basic Principles of Anti-Neoplastic Therapies.- Neoadjuvant Endocrine Therapy in the Treatment of Early-Stage Breast Cancer.- Neoadjuvant Systemic Therapy For Breast Cancer.- Adjuvant Systemic Therapy.- Adjuvant Endocrine Therapy.- Systemic Treatment During Pregnancy.- Breast Cancer in the Elderly.- Complementary and Alternative Medicine in Breast Cancer.- Section Twelve - Radiation Therapy of the Breast.- Basic Principles Of Radiobiology.- Whole Breast Radiotherapy.- Accelerated, Partial Breast Irradiation Overview.- PBI: Brachytherapy Techniques.- Accelerated Partial Breast Irradiation: Balloon Catheter Brachytherapy.- APBI 3DConformal External Beam - The NYU Technique.- Accelerated, Partial Breast Irradiation with Intraoperative Radiotherapy.- Post-Mastectomy Radiation Therapy.- Regional Nodal Radiation as an Alternative to Surgery.- Controversial Indications For Breast Conserving Therapy And Radiation.- Section Thirteen - The Breast Cancer Survivor.- Survivorship.- Follow-up Strategies After Breast Cancer Treatment.- Pregnancy After Breast Cancer.- The Potential of the Electronic Health Record in the Breast Center.- Clinical Breast Examination After Treatment of Breast Cancer.- Breast Imaging Following Breast Conservation Therapy.- Detection and Management of Ipsilateral Breast Cancer Recurrence.- Lumpectomy or Mastectomy in Patients Presenting with Metastatic Disease.- Managing Breast Cancer- Associated Lymphedema.- Chronic Pain After Surgery for Breast Cancer.- Systemic Treatment Of Metastatic Breast Cancer

Frederick M. Dirbas, M.D. Associate Professor of Surgery Breast Disease Management Group Leader Clinical Care Sub-Team Division of Surgical Oncology Department of Surgery Stanford University School of Medicine, Stanford Cancer Center 875 Blake Wilbur Drive, CC2235 Stanford, CA 94025, USA Carol E. H. Scott-Conner, M.D., Ph.D. Department of Surgery University of Iowa Hospitals and Clinic 200 Hawkins Drive, 1516 JCP Iowa City, IA 52242-1086, USA

• Foreword.- Section One-Fundamentals.- Professionalism in the Approach to the Patient.- The Clinical Breast Cancer Team.- The Role of the Specialist Breast Nurse.- Social Work and Breast Cancer Care.- Reducing Medical Malpractice Risk in Breast Cancer Care: A Surgical Perspective.- Career Development for Breast Surgical Oncology.- Successful Management of a Breast Surgery Practice.- Section Two-Biologic Principles.- Normal Morphology, Physiological Changes, and Benign Breast Disease.- The Biology of Breast Cancer.- Section Three-Initial Evaluation of the Patient.- Obtaining a History and Performing the Clinical Breast Examination.- Primer on Ultrasound for the Breast Surgeon.- The Complete Radiology Workup.- Section Four-Common Presenting Complaints and Concerns.- Identification and Management of Women at High Familial Risk for Breast Cancer.- Clinical Management of Breast Pain.- Breast Mass.- Breast Infection.- The Evaluation and Treatment of Nipple Discharge.- Gynecomastia.- The Effects of Menopausal Hormone Therapy on Breast Cancer: Evidence from the Women’s Health Initiative Randomized Placebo-Controlled Trials.- Section Five-Diagnostic Techniques.- Office Diagnostic Procedures.- Image-Guided Breast Biopsy.- Breast Biopsy Techniques.- Mammary Ductoscopy.- Section Six - Breast Cancer Overview.- Assessment Of Extent Of Disease In Primary Breast Cancer.- Breast Cancer Staging: Predicting Outcome and Response to Treatment.- Breast Cancer Treatment Guidelines.- Introduction to Gene Expression Profiling in Breast Cancer.- Clinical Trial Overview and Enrollment.- Psychiatric and Psychological Issues.- Fertility Issues for Newly Diagnosed Women Interested in Child Bearing – Strategies and Options.- Section Seven - Breast Surgery – Management of the Primary Tumor.- Regional Anesthesia for Breast Surgery.- Lumpectomy.- Oncoplastic Techniques for Breast Conservation Surgery.- Ablative Techniques.- Mastectomy.- Nipple and Areola-Sparing Mastectomy.- Integration ofNeoadjuvant Systemic Therapy Into Surgical Practice.- Oncologic Breast Reconstruction: Principles and Practice.- Section Eight - Breast Surgery – Sentinel Node Biopsy and Axillary Dissection.- Sentinel Lymph Node Biopsy—an Overview.- Sentinel Lymph Node Biopsy: Radiotracer Technique at Memorial Sloan-Kettering Cancer Center.- Sentinel Node Biopsy Using Lymphazurin.- The Use of Methylene Blue as a Tracer Agent in Sentinel Lymph Node Biopsy.- Axillary Lymph Node Dissection.- Section Nine - Breast Surgery – Special Issues.- Evaluation and Management of Women Presenting with Breast Symptoms During Pregnancy.- Paget’s Disease Of The Breast.- Male Breast Cancer.- Breast Sarcomas.- Axillary Metastases with Unknown Primary.- Section Ten - Cytology and Pathology.- Breast Cytology.- The Breast Pathology Report.- Risk Lesions of the Breast: Usual Ductal Hyperplasia, Atypical Ductal Hyperplasia, Lobular Neoplasia, and the Spectrum of Columnar Cell Alterations.- Duct Carcinoma In Situ – a Gordian Knot Untied.- Pathology: Invasive Carcinoma.- Interpreting Breast Pathology in the Setting of Neoadjuvant Chemotherapy.- Pathology of Sentinel Lymph Nodes and Axillary Nodes.- Selected Fibroepithelial, Mesenchymal and Hematolymphoid Tumors of the Breast.- Banking tissue specimens for research.- Section Eleven - Systemic Therapy for Breast Cancer.- Basic Principles of Anti-Neoplastic Therapies.- Neoadjuvant Endocrine Therapy in the Treatment of Early-Stage Breast Cancer.- Neoadjuvant Systemic Therapy For Breast Cancer.- Adjuvant Systemic Therapy.- Adjuvant Endocrine Therapy.- Systemic Treatment During Pregnancy.- Breast Cancer in the Elderly.- Complementary and Alternative Medicine in Breast Cancer.- Section Twelve - Radiation Therapy of the Breast.- Basic Principles Of Radiobiology.- Whole Breast Radiotherapy.- Accelerated, Partial Breast Irradiation Overview.- PBI: Brachytherapy Techniques.- Accelerated Partial Breast Irradiation: Balloon Catheter Brachytherapy.- APBI 3DConformal External Beam - The NYU Technique.- Accelerated, Partial Breast Irradiation with Intraoperative Radiotherapy.- Post-Mastectomy Radiation Therapy.- Regional Nodal Radiation as an Alternative to Surgery.- Controversial Indications For Breast Conserving Therapy And Radiation.- Section Thirteen - The Breast Cancer Survivor.- Survivorship.- Follow-up Strategies After Breast Cancer Treatment.- Pregnancy After Breast Cancer.- The Potential of the Electronic Health Record in the Breast Center.- Clinical Breast Examination After Treatment of Breast Cancer.- Breast Imaging Following Breast Conservation Therapy.- Detection and Management of Ipsilateral Breast Cancer Recurrence.- Lumpectomy or Mastectomy in Patients Presenting with Metastatic Disease.- Managing Breast Cancer- Associated Lymphedema.- Chronic Pain After Surgery for Breast Cancer.- Systemic Treatment Of Metastatic Breast Cancer

Frederick M. Dirbas, M.D. Associate Professor of Surgery Breast Disease Management Group Leader Clinical Care Sub-Team Division of Surgical Oncology Department of Surgery Stanford University School of Medicine, Stanford Cancer Center 875 Blake Wilbur Drive, CC2235 Stanford, CA 94025, USA Carol E. H. Scott-Conner, M.D., Ph.D. Department of Surgery University of Iowa Hospitals and Clinic 200 Hawkins Drive, 1516 JCP Iowa City, IA 52242-1086, USA

• Foreword.- Section One-Fundamentals.- Professionalism in the Approach to the Patient.- The Clinical Breast Cancer Team.- The Role of the Specialist Breast Nurse.- Social Work and Breast Cancer Care.- Reducing Medical Malpractice Risk in Breast Cancer Care: A Surgical Perspective.- Career Development for Breast Surgical Oncology.- Successful Management of a Breast Surgery Practice.- Section Two-Biologic Principles.- Normal Morphology, Physiological Changes, and Benign Breast Disease.- The Biology of Breast Cancer.- Section Three-Initial Evaluation of the Patient.- Obtaining a History and Performing the Clinical Breast Examination.- Primer on Ultrasound for the Breast Surgeon.- The Complete Radiology Workup.- Section Four-Common Presenting Complaints and Concerns.- Identification and Management of Women at High Familial Risk for Breast Cancer.- Clinical Management of Breast Pain.- Breast Mass.- Breast Infection.- The Evaluation and Treatment of Nipple Discharge.- Gynecomastia.- The Effects of Menopausal Hormone Therapy on Breast Cancer: Evidence from the Women’s Health Initiative Randomized Placebo-Controlled Trials.- Section Five-Diagnostic Techniques.- Office Diagnostic Procedures.- Image-Guided Breast Biopsy.- Breast Biopsy Techniques.- Mammary Ductoscopy.- Section Six - Breast Cancer Overview.- Assessment Of Extent Of Disease In Primary Breast Cancer.- Breast Cancer Staging: Predicting Outcome and Response to Treatment.- Breast Cancer Treatment Guidelines.- Introduction to Gene Expression Profiling in Breast Cancer.- Clinical Trial Overview and Enrollment.- Psychiatric and Psychological Issues.- Fertility Issues for Newly Diagnosed Women Interested in Child Bearing – Strategies and Options.- Section Seven - Breast Surgery – Management of the Primary Tumor.- Regional Anesthesia for Breast Surgery.- Lumpectomy.- Oncoplastic Techniques for Breast Conservation Surgery.- Ablative Techniques.- Mastectomy.- Nipple and Areola-Sparing Mastectomy.- Integration ofNeoadjuvant Systemic Therapy Into Surgical Practice.- Oncologic Breast Reconstruction: Principles and Practice.- Section Eight - Breast Surgery – Sentinel Node Biopsy and Axillary Dissection.- Sentinel Lymph Node Biopsy—an Overview.- Sentinel Lymph Node Biopsy: Radiotracer Technique at Memorial Sloan-Kettering Cancer Center.- Sentinel Node Biopsy Using Lymphazurin.- The Use of Methylene Blue as a Tracer Agent in Sentinel Lymph Node Biopsy.- Axillary Lymph Node Dissection.- Section Nine - Breast Surgery – Special Issues.- Evaluation and Management of Women Presenting with Breast Symptoms During Pregnancy.- Paget’s Disease Of The Breast.- Male Breast Cancer.- Breast Sarcomas.- Axillary Metastases with Unknown Primary.- Section Ten - Cytology and Pathology.- Breast Cytology.- The Breast Pathology Report.- Risk Lesions of the Breast: Usual Ductal Hyperplasia, Atypical Ductal Hyperplasia, Lobular Neoplasia, and the Spectrum of Columnar Cell Alterations.- Duct Carcinoma In Situ – a Gordian Knot Untied.- Pathology: Invasive Carcinoma.- Interpreting Breast Pathology in the Setting of Neoadjuvant Chemotherapy.- Pathology of Sentinel Lymph Nodes and Axillary Nodes.- Selected Fibroepithelial, Mesenchymal and Hematolymphoid Tumors of the Breast.- Banking tissue specimens for research.- Section Eleven - Systemic Therapy for Breast Cancer.- Basic Principles of Anti-Neoplastic Therapies.- Neoadjuvant Endocrine Therapy in the Treatment of Early-Stage Breast Cancer.- Neoadjuvant Systemic Therapy For Breast Cancer.- Adjuvant Systemic Therapy.- Adjuvant Endocrine Therapy.- Systemic Treatment During Pregnancy.- Breast Cancer in the Elderly.- Complementary and Alternative Medicine in Breast Cancer.- Section Twelve - Radiation Therapy of the Breast.- Basic Principles Of Radiobiology.- Whole Breast Radiotherapy.- Accelerated, Partial Breast Irradiation Overview.- PBI: Brachytherapy Techniques.- Accelerated Partial Breast Irradiation: Balloon Catheter Brachytherapy.- APBI 3DConformal External Beam - The NYU Technique.- Accelerated, Partial Breast Irradiation with Intraoperative Radiotherapy.- Post-Mastectomy Radiation Therapy.- Regional Nodal Radiation as an Alternative to Surgery.- Controversial Indications For Breast Conserving Therapy And Radiation.- Section Thirteen - The Breast Cancer Survivor.- Survivorship.- Follow-up Strategies After Breast Cancer Treatment.- Pregnancy After Breast Cancer.- The Potential of the Electronic Health Record in the Breast Center.- Clinical Breast Examination After Treatment of Breast Cancer.- Breast Imaging Following Breast Conservation Therapy.- Detection and Management of Ipsilateral Breast Cancer Recurrence.- Lumpectomy or Mastectomy in Patients Presenting with Metastatic Disease.- Managing Breast Cancer- Associated Lymphedema.- Chronic Pain After Surgery for Breast Cancer.- Systemic Treatment Of Metastatic Breast Cancer