This volume is a contemporary guide to the management of breast diseases, both benign and malignant. This multidisciplinary resource includes significant expertise from the disciplines of radiology, pathology, oncology, psychology, and nursing care, as well as insights from plastic surgeons and other allied health professionals.



With a focus on practical patient management, the book takes a problem-based learning approach and includes strategies to tackle clinical challenges which, whilst seen in practice, are often poorly understood and taught.



Each chapter succinctly covers the seminal evidence-based literature whilst placing this within a patient-centred context. The multidisciplinary approach reflects contemporary clinical practice.



Breast surgeons, surgeons in training positions, and the wider multidisciplinary breast management team will all benefit from this authoritative guide.





EDITORS


Ashok Subramanian B.Sc (Hons), MBBS (Hons), FRCS (Gen) Consultant Oncoplastic Surgeon,

College Tutor for Surgery ESHT



Mark William Kissin MA, MChir, FRCS Engl. BCA(h) Consultant Specialist Breast Surgeon to the

Guilford Hospitals, Quality Assurance Breast Surgeon throughout South East England



Professor David C Howlett MBBS PhD FAcadMEd FRCP(Lond) FRCP(Edin) FRCR Consultant

Radiologist - East Sussex Healthcare NHS Trust, Honorary Clinical Professor Radiology - Brighton

and Sussex Medical School



Dr Jennifer Glendenning MBBS BSc MRCP FRCR MDres Consultant Clinical Oncologist Kent Oncology Centre


Section I

Family History and High-Risk Surveillance

Lis Grimsey

The Principles of Triple Assessment

Annaliese Lawn and Hannah Knowles

Breast Screening

Sue Barter

Mammography and Ultrasound

William Teh, Leila Ismail and Gary Rubin

MRI

William Teh, Konstantia Diana Stavrou

Localisation and Biopsy

William Teh, Mia Morgan

Traditional Histopathology of Breast Cancer

Wen Ng and Sarah E. Pinder

The Management of B3 Lesions

Wen Ng and Sarah E. Pinder

The Management of Phyllodes

Manish Kothari and Rahul Deb

The Management of Intraduct Papillomas

Manish Kothari and Rahul Deb

The Evolution of the MDT

Mark Sibbering and Brenda Muntean



Section II First Treatment

Neo-Adjuvant Hormone Blockade

Amna Sheri

Neo-Adjuvant Chemotherapy

Judy King, Valerie Crolley, Alison Jones

Multifocal and Multicentric Disease

Zoe Winters and Adam Heetun

Wide Excision or Mastectomy

Meera Joshi, Pooja Padmanabhan, and Elizabeth Clayton

Mastectomy Plus or Minus Reconstruction

Farrokh Pakzad

The Mystery of DCIS

Arany Soosainathan & Mark Kissin

The Bigger Mystery of LCIS

Giles Cunnick and V Passi

Learning About Lobular

Elizabeth Sharp & Veronika Pronisceva

Anaesthesia and Analgesia

Tara Bolton & James Bennett

Day Case Surgery

Jo Marsden

The ERAS Nurse

Radhika Merh



Section III Conversations about Conservation

Incision Planning and Operating on Difficult Areas

Ash Subramanian

Perforator Breast Flaps

Peter Barry and Tania de Silva

Oncoplastic Wide Excision

Alison Hunter-Smith and Richard Sutton



Section IV Rebuilding the Breast

Timing of Reconstruction

Zoe Winters

The Effects of Radiotherapy on Reconstruction

Radhika Merh

Nipple Sparing Mastectomy

Jennifer Rusby and Rachel o'Connell

Sub-Pectoral Implants

Tracey Irvine, Noor Obeid and Carol Norman

Pre-Pectoral Implants

Soni Soumian and Mihir Chandarana

Latissimus Dorsi Flaps

Mark Kissin

Free Flaps

David Thomson and Alexandra Molina

Lipomodelling

Stacy Wardle, Riccardo Bonomi, I. Fabio Rapisarda, Lorna Cook, Dibendu Betal

Nipple Reconstruction

David Thomson and Alexandra Molina



Section V Managing the Axilla: Less is More?

Management of the Axilla



Section VI Oncology

Hormonal Blockade

Jenny Glendenning and Russell Burscombe

Chemotherapy

Raj Sinha

Radiotherapy

Shirin Namini

Complementary Alternative Medicine

Mark Kissen and Jessica Richards

Patterns of Recurrence

Jessica Gough, Samantha Forner, Sarah Hunter, Jennifer Glendenning

Locoregional Inoperable Recurrence

Jessica Gough, Samantha Forner, Sarah Hunter, Jennifer Glendenning

The Value of Radiology from Diagnosis to Distant Relapse

Steve Allen and Emily Daulton

Palliative Care

Luci Cook and Farida Malik



Section VII Tomorrow's World

Predictive Assays and New Taxonomy

Wen Ng and Sarah Pinder

Modern Pathology

Wen Ng and Sarah Pinder

Breast Cancer Genetics

Julian Barwell and Maurice Dungey

Technical Innovations

Edward St John, Rachel O'Connell & Daniel Leff

Advances in Radiology

Jiyon Lee

Advances in Oncology

Vasileios Angelis and Catherine Harper-Wynne

Future Roles of the Breast Nurse

Claire Ryan



Section VIII Survivorship

To Follow-Up or not to Follow Up: That is the Question

Ash Subramanian and Mark Kissin

Modifiable Risk Factors

Adam Heetun, Ellen Copson, Ramsey Cutress

Lymphoedema

Tania de Silva

Long Term Implications of Radiotherapy and Chemotherapy

Van Sim, Samantha Forner, Jennifer Glendenning

Psychological Effects of Oncoplastic Surgery

Diana Harcourt



Section IX The Difficult Scenario

Young and Pregnant Women

David Bloomfield and Mariana Velasco Bloomfield

Fertility Issues

David Bloomfield and Mariana Velasco Bloomfield

The BRCA Positive Patient

Andrew Baildam

Risk Reducing Mastectomy

Ross Kenny

The Older Woman

Richard Simcock

Male Breast Cancer

Ian S. Fentiman



Section X The Principles of Cosmetic Breast Surgery

Augmentation

Marc Pacifico

Implants

Marc Pacifico

Reduction and Mastopexy

Alison Hunter-Smith and Anne Tansley

Gynaecomastia

Ian S. Fentiman



Section XI Maintaining Good Practice

Probity and Professional Standards

Ashu Gandhi

Dealing with Complaints

Tim Davidson

Collecting Data and Statistics

Dee Daly

Getting It Right First Time

Tracey Irvine, Carol Norman, and Noor Obeid

Social Media for the Breast

Adam Heetun

3D Modelling for Aesthetics

Frederico Roldao and Alejandro Maciel, Jesús F Escrivá-Machado, Terri Coutee, Ash Subramanian

The Effect of the COVID-19 Pandemic

Cliona Kirwan and Rajiv Dave