Management of the Patient at High Risk for Breast Cancer
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1 Management of the Patient at High Risk for Breast Cancer
2 wwwwwwwwwwww
3 Nora M. Hansen Editor Management of the Patient at High Risk for Breast Cancer
4 Editor Nora M. Hansen Feinberg School of Medicine Division of Breast Surgery Northwestern University Chicago, IL, USA ISBN ISBN (eBook) DOI / Springer New York Heidelberg Dordrecht London Library of Congress Control Number: Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (
5 Preface and Acknowledgements This book Management of the Patient at High Risk for Breast Cancer is designed to meet the needs of physicians involved in the care of patients who are at increased risk for developing breast cancer. The goal is to provide upto-date and evidence-based information on all aspects of care for those who are at an increased risk for developing breast cancer. I am extremely grateful to all of the contributing authors for their time and their expertise, and I thank them for their contributions. I would also like to thank my assistant Burton Korman for all the hard work he put into making this book become a reality. I would especially like to thank Maria Smilios, my developmental editor, who worked tirelessly on this project and kept the project moving forward. I believe as physicians we cannot underestimate the psychological stress that patients experience when they realize that they are at an increased risk for developing breast cancer. Our goal is to provide our patients with the necessary information which will allow them to make informed decisions about either surveillance of their breasts or interventions to reduce their risk from either a medical or a surgical approach. I hope that the information in this book will serve as a strong foundation of knowledge in order to better care for this group of patients. I would like to dedicate this book to my parents who have always supported me in everything I do. My late father, Dr. Gerard Hansen, who was a practicing obstetrician and gynecologist would have been thrilled to see this book become a reality. My mother, Peggy Hansen, has been a true inspiration to me and her strength, courage, and support have helped shape me into the person I have become. Chicago, IL, USA Nora M. Hansen MD v
6 wwwwwwwwwwww
7 Contents 1 Identifying Women at High Risk of Breast Cancer: Understanding the Risk Models... 1 Scott M. Weissman 2 Genetic and Genomic Factors in Breast Cancer Lee P. Shulman 3 BRCA Mutation Ashley N. Hardy, Elizabeth Tarasewicz, and Jacqueline S. Jeruss 4 High Risk Breast Lesions and Pathologic Evaluation Thomas J. Lawton 5 Management of High-Risk Lesions Christine M. Gresik and Seema A. Khan 6 Radiological Imaging for the High-Risk Patient Erin Neuschler and Paula Grabler 7 Risk Reduction Strategies: Medical Oncology Virginia Kaklamani 8 Risk Reduction Strategies: Surgical Perspective Lisa Renee-Palko Spiguel and Nora Hansen 9 Options and Advances in Breast Reconstruction John Y.S. Kim, Vinay Rawlani, and Jennifer E. Cheesborough 10 Management of Concomitant Risk Megan E. Miller, Sarah M. Nielsen, and Swati A. Kulkarni 11 Psychological Implications of Testing Positive for the BRCA Gene Timothy Pearman 12 The High-Tech High Risk Clinic Brian Drohan, Constance Roche, and Kevin S. Hughes vii
8 viii Contents 13 Current and Future Direction in Basic and Translational Research Susan M. Love Index
9 Contributors Jennifer E. Cheesborough, MD Division of Plastic and Reconstructive Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Brian Drohan, PhD Department of Surgical Oncology, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Paula Grabler, MD Department of Radiology, Northwestern Memorial Hospital, Chicago, IL, USA Christine M. Gresik, MD Lynn Sage Comprehensive Breast Center, Feinberg School of Medicine of Northwestern University, IL, USA Nora M. Hansen, MD Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Ashley N. Hardy, MD Department of Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Kevin S. Hughes, MD, FACS Department of Surgical Oncology, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Jacqueline S. Jeruss, MD, PhD Department of Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Virginia Kaklamani, MD, DSc Division Hematology/Oncology, Northwestern University, Chicago, IL, USA Seema A. Khan, MD Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA John Y.S. Kim, MD Division of Plastic and Reconstructive Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Swati A. Kulkarni, MD Department of Surgery, The University of Chicago Medical Center, Chicago, IL, USA Thomas J. Lawton, MD Pacific Breast Pathology Medical Corporation, Novato, CA, USA Susan M. Love, MD, MBA, FACS Dr. Susan Love Research Foundation, Santa Monica, CA, USA ix
10 x Contributors Megan E. Miller, MD Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA Sarah M. Nielsen, MS, CGC Department of Hematology/Oncology, The University of Chicago Medical Center, Chicago, IL, USA Erin Neuschler, MD Department of Breast Imaging, Northwestern Memorial Hospital, Chicago, IL, USA Timothy Pearman, PhD Supportive Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA Department of Medical Social Sciences, Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Vinay Rawlani, MD Division of Plastic and Reconstructive Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Constance Roche, BSN, MSN, ANP-BC, ONC, APNG Department of Surgical Oncology, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Lee P. Shulman, MD Division of Clinical Genetics, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA Northwestern Ovarian Cancer Early Detection and Prevention Program, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA Cancer Genetics Program, Robert S. Lurie Comprehensive Cancer Center, Feinberg School of Medicine of Northwestern University, Chicago, IL, USA Department of Obstetrics and Gynecology, Prentice Women s Hospital, Northwestern Memorial Hospital, Chicago, IL, USA Lisa Renee-Palko Spiguel, MD McGaw Medical Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Elizabeth Tarasewicz, BS Department of Surgery, Northwestern Memorial Hospital, Chicago, IL, USA Scott M. Weissman, MS, CGC NorthShore University HealthSystem, Center for Medical Genetics, Evanston, IL, USA
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