c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Breast Cancer: Overview: 25

A D V E R T I S E M E N T

   
 

Another option for reconstruction is to rebuild a breast mound using skin and muscle (musculocutaneous flap) from another area of the body. The lower abdominal skin and rectus abdominus muscle (TRAM flap) are most commonly used. This has the added benefit of a simultaneous tummy tuck. The benefit of natural tissue is elimination of a foreign material implant, but it does add major surgery.      

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Breast Cancer: Overview: 26

A D V E R T I S E M E N T

   
 

Fortunately, locally advanced disease (stage III) is rarely seen any more. One form of locally advanced disease is called inflammatory cancer. Invasion of skin lymphatics causes redness and swelling of the skin, and the prognosis is very poor. In order to try to reduce the stage or the disease prior to attempting local control, chemotherapy is given first (neo-adjuvant chemotherapy).      

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Breast Cancer: Overview: 27

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If there is evidence of locally advanced disease, a metastatic survey is added to the routine evaluations to try and detect metastatic disease early. This usually includes a whole body bone scan and may include a head CT scan. If distant spread is found, systemic therapy takes precedence, and local therapy becomes secondary.

Some patients with metastatic disease may be candidates for radical chemotherapy in the setting of an experimental protocol. Because the massive chemotherapy wipes out the blood-forming elements in the bone marrow, a bone-marrow transplant is necessary.

Support

Breast cancer puts a great physical and psychological strain on the patient, her family, and friends. Fortunately, most large centers are using a team approach that includes nurse managers who coordinate the various aspects of treatment and act as the patient's steady point of contact.

Resources 

There are a number of excellent sources of additional information on breast cancer available to the patient. Among those on the Internet, the National Institutes of Health website at http://cancernet.nci.nih.gov/clinpdq/soa/breast_cancer_physician.html includes a wide range of educational information and information on current clinical trials.  

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This page was last modified on 7/8/1999.