Book contents
- Frontmatter
- Contents
- Preface
- Acknowledgements
- Glossary
- Abbreviations
- 1 Basics of breast MRI
- 2 Imaging-related anatomy and pathology
- 3 Interpreting breast MRI studies
- 4 MRI-guided biopsy techniques
- 5 High-risk screening using breast MRI
- 6 Preoperative staging with breast MRI
- 7 Problem-solving applications of breast MRI
- 8 MRI after breast augmentation
- Answers to multiple choice questions
- Appendices
- 1 Nephrogenic systemic fibrosis
- 2 Sensitivity and specificity
- 3 TNM classification
- 4 Overview of surgical procedures
- 5 Overview of radiation therapy
- 6 Overview of systemic therapy
- 7 Primary prevention strategies for high-risk women
- 8 Breast cancer genes and genetic testing
- Index
- Plate section
6 - Overview of systemic therapy
Published online by Cambridge University Press: 05 March 2012
- Frontmatter
- Contents
- Preface
- Acknowledgements
- Glossary
- Abbreviations
- 1 Basics of breast MRI
- 2 Imaging-related anatomy and pathology
- 3 Interpreting breast MRI studies
- 4 MRI-guided biopsy techniques
- 5 High-risk screening using breast MRI
- 6 Preoperative staging with breast MRI
- 7 Problem-solving applications of breast MRI
- 8 MRI after breast augmentation
- Answers to multiple choice questions
- Appendices
- 1 Nephrogenic systemic fibrosis
- 2 Sensitivity and specificity
- 3 TNM classification
- 4 Overview of surgical procedures
- 5 Overview of radiation therapy
- 6 Overview of systemic therapy
- 7 Primary prevention strategies for high-risk women
- 8 Breast cancer genes and genetic testing
- Index
- Plate section
Summary
Systemic therapies have two main aims – first to reduce the risk of future local recurrence and to treat possible distant metastatic disease. Toxic chemotherapy is not appropriate for pathologically pure DCIS, as there is only a 1–2% rate of subsequent metastases arising. Nevertheless as DCIS becomes more extensive, so the risk increases that pathologically occult microinvasion may be present and surgeons frequently perform SLNB for DCIS cases of > 30–40 mm in extent.
Most young women with invasive cancer are offered chemotherapy, with the Adjuvant! Online algorithm being widely used as a means of taking into account several important variables (tumor size, tumor grade, nodal status, receptor status) to provide an indication of overall % survival benefit. In older patients with EBC, chemotherapy may only offer significant additional survival benefit for ER-negative cancers.
- Type
- Chapter
- Information
- Handbook of Breast MRI , pp. 199 - 200Publisher: Cambridge University PressPrint publication year: 2011