Contents
I Basic Science
1 Gross Anatomy of the Breast and Axilla .......................................................................................................... 3
Peter Palhazi
2 Physiology and Developmental Stages of the Breast ............................................................................. 11
Theodore G. Troupis, Adamantios Michalinos, George Skandalakis, and Panayiotis Skandalakis
3 Breast Cancer Epidemiology .................................................................................................................................... 19
R.M. Parks, M.G.M. Derks, E. Bastiaannet, and K.L. Cheung
4 Effect of Oestrogen Exposure, Obesity, Exercise and Diet
on Breast Cancer Risk ................................................................................................................................................... 31
Eleni Th. Petridou, Marios K. Georgakis, and Constantine N. Antonopoulos
5 Hereditary Breast Cancer Genetics and Risk Prediction Techniques ............................................ 43
Helena Carley and Anju Kulkarni
II Screening, High Risk Lesions, and Risk Management
6 Screening for High-Familial- Risk Women ....................................................................................................... 59
Athina Vourtsis
7 Risk-Reducing Breast and Ovarian Surgery for Women at High Familial Risk ....................... 69
Inkeri Schultz and Kerstin Sandelin
8 The Role of Breast Cancer Chemoprevention in High-Risk Women ............................................... 79
Lynda Wyld
9 Molecular Profiling of Breast Cancer and DCIS ........................................................................................... 89
Christos Markopoulos
10 P athology of High-Risk Breast Lesions ............................................................................................................. 103
Sarah E. Pinder and Abeer M. Shaaban
11 Ductal Carcinoma in Situ ............................................................................................................................................ 115
Stacey A. Carter, Sarah E. Pinder, and Alastair M. Thompson
12 Imaging of the Breast ................................................................................................................................................... 127
Petra Steyerova
13 Breast Cancer Screening ............................................................................................................................................. 147
John Mathew and Mark Sibbering
III Early Breast Cancer: Diagnosis and Management
14 Clinical Presentation, Diagnosis and Staging of Breast Cancer ....................................................... 159
Janez Zgajnar

15 Pathology of Breast Cancer ...................................................................................................................................... 177
Frederique Penault-Llorca and Nina Radosevic-Robin
16 The Breast and Oncoplastic Multidisciplinary Team ................................................................................ 193
Fiona MacNeill, Marios Konstantinos Tasoulis, and Melissa Ley Hui Tan
17 Surgery to the Breast: Mastectomy ..................................................................................................................... 203
Petros Charalampoudis and Tibor Kovacs
18 Surgery to the Breast: Breast Conservation Techniques ....................................................................... 213
Marjut Leidenius
19 Oncoplastic Breast-Conserving Therapy ......................................................................................................... 229
Elias E. Sanidas and Florian Fitzal
20 Fat Transfer in Oncoplastic and Reconstructive Breast Surgery ...................................................... 245
Riccardo Bonomi, I. Fabio Rapisarda, Gilles Toussoun, and Loraine Kalra
21 Breast Surgery after Primary Systemic Treatment .................................................................................... 255
Thorsten Kuehn
22 Surgery for Locally Recurrent Breast Cancer ................................................................................................ 263
Roberto Agresti, Andrea Spano, Giulia Bianchi, and Giovanna Trecate
23 Management of the Axilla: Sentinel Lymph Node Biopsy ................................................................... 275
Leif Bergkvist and Jan Frisell
24 Axillary Node Clearance ............................................................................................................................................. 285
Tuomo J. Meretoja
25 Axillary Management in the Neoadjuvant Setting ................................................................................... 291
K. Wimmer, F. Fitzal, R. Exner, and M. Gnant
26 Axillary Reverse Mapping: ARM ............................................................................................................................ 303
Isabel T. Rubio, Ernest J.T. Luiten, and V. Suzanne  Klimberg
IV Reconstructive Surgery
27 Immediate Reconstruction: General and Oncological Considerations ....................................... 315
Maria João Cardoso and Giuseppe Catanuto
28 Delayed Breast Reconstruction: General and Oncological Considerations ............................. 325
Zoltán Mátrai
29 Breast Implants: Design, Safety and Indications for Use ...................................................................... 355
Jana de Boniface and Inkeri Schultz
30 Specific Implant-Based Techniques for Breast Reconstruction ........................................................ 365
Lorna J. Cook and Michael Douek
31 Specific Autologous Flap Techniques ................................................................................................................ 381
Sinikka Suominen and Maija Kolehmainen

32 Goldilocks Procedure ................................................................................................................................................... 393
Fiona MacNeill
33 Nipple Reconstruction ................................................................................................................................................. 401
Valentina Lefemine and Kelvin F. Gomez
34 Complications of Breast Surgery and Their Management ................................................................... 411
Michalis Kontos and Christos Markopoulos
V Adjuvant Therapy for Early Breast Cancer
35 Adjuvant Endocrine Therapy ................................................................................................................................... 427
Manuela Rabaglio and Monica Castiglione
36 Adjuvant Chemotherapy ............................................................................................................................................ 439
Giuseppe Curigliano, Angela Esposito, and Carmen Criscitiello
37 Adjuvant Molecular Therapies in Breast Cancer ......................................................................................... 447
A. Prove, L.-A. Teuwen, and L. Dirix
38 Primary Systemic Therapy for Breast Cancer ................................................................................................ 453
Cornelia Liedtke and Hans-Christian Kolberg
39 Radiotherapy for Breast Cancer ............................................................................................................................ 463
Barbara Alicja Jereczek-Fossa, Maria Cristina Leonardi, and Samantha Dicuonzo
VI Breast Cancer in Special Groups
40 Breast Cancer in Special Groups: Young Women with Early Breast Cancer .............................. 487
Rossella Graffeo and Olivia Pagani
41 Hereditary Breast Cancer ........................................................................................................................................... 499
Teresa Ramón y Cajal, Anna Virgili, and Nuria Dueñas
42 Breast Cancer in Special Groups: Breast Cancer in Pregnancy ......................................................... 511
Matteo Lambertini, Hatem A. Azim Jr, and Fedro Alessandro Peccatori
43 Fertility Preservation in Women with Breast Cancer ............................................................................... 521
Anna Rachelle Mislang, Matteo Lambertini, and Laura Biganzoli
44 Breast Cancer in Older Patients ............................................................................................................................. 529
Anne Shrestha and Lynda Wyld
45 Breast Cancer in the Male Patient ........................................................................................................................ 541
M. Umit Ugurlu and Bahadir M. Gulluoglu
46 Sarcoma of the Breast .................................................................................................................................................. 551
Erkki Tukiainen and Andrew Lindford
47 Desmoid (Aggressive) Fibromatosis of the Breast .................................................................................... 559
Nicholas C. Eastley, Jaroslaw Krupa, and Robert U. Ashford

VII Advanced Breast Cancer
48 Locally Advanced Breast Cancer ........................................................................................................................... 567
Elżbieta Senkus and Aleksandra Łacko
49 Metastatic Breast Cancer: Prognosis, Diagnosis and Oncological Management ................. 579
Elżbieta Senkus and Aleksandra Łacko
50 The Role of Surgery in Metastatic Disease to the Bone ......................................................................... 595
Amit Kumar and Robert U. Ashford
51 Roles of Surgery and Modern Radiation Techniques in Metastatic
Disease Affecting the Brain ...................................................................................................................................... 603
Garth Cruickshank
52 Local Therapies for Liver Metastases from Breast Cancer .................................................................... 613
Robert P. Jones, Hassan Z. Malik, and Carlo Palmieri
53 Role of Surgery in Lung Metastases from Breast Cancer ...................................................................... 619
Michael Shackcloth and Susannah Love
54 Surgery for Locally Advanced Breast Cancer ................................................................................................ 625
Jaroslaw Skokowski and Pawel Kabata
55 The Role of Surgery to the Primary Cancer in Stage IV Disease ....................................................... 633
Seema A. Khan and Patience Odele
56 Palliative Care .................................................................................................................................................................... 641
Tiina Saarto
57 Supportive Care ............................................................................................................................................................... 649
Renata Zaucha
VIII Survivorship
58 Breast Cancer Survivorship: Chronic Post-operative Pain
and Sensory Changes ................................................................................................................................................... 659
Tuomo J. Meretoja
59 Breast Cancer Survivorship: Psychological Distress, Body Image, Sexuality
and Importance of the Clinical Consultation ................................................................................................ 663
Louise Fairburn, Christopher Holcombe, and Helen Beesley
60 Bone Health in Patients with Breast Cancer .................................................................................................. 673
Amy Kwan and Janet E Brown
61 Nursing Issues and the Role of the Specialist Nurse in Breast Care .............................................. 681
Victoria Harmer
62 Breast Cancer-Related Lymphedema ................................................................................................................. 689
Heli Kavola and Sinikka Suominen

IX Quality Assurance
63 Research and Audit in Advancing the Quality of Breast Cancer Care .......................................... 703
Petra G. Boelens, Elma Meershoek-Klein Kranenbarg, Esther Bastiaannet,
Cornelis van de Velde, and Riccardo A. Audisio
X Appendix
64 MCQ Self-Test ..................................................................................................................................................................... 715
Lynda Wyld and Christos Markopoulos
Supplementary Information
Index .......................................................................................................................................................................................... 721