Multidisciplinary frontiers in breast cancer management: a surgeon's perspective.

摘要: The current paradigm of breast cancer management may be altered significantly over the coming years by adoption new treatment schema and devices outside surgical arena. New advances in imaging will improve our ability to detect early-stage disease but also assist monitoring outcomes support development nonsurgical ablation techniques. These advances, some already use, include a 3-dimensional adaptation digital mammography, color Doppler ultrasonography that can visualize neovascularization growing tumors, contrast-enhanced magnetic resonance with improved accuracy for detection occult cancers, specialized approach positron emission tomography designed use on breast, nanoparticle contrast agents visualized near-infrared light. Systemic therapy, which revolutionized last half 20th century, is being reconceptualized, attention turning adjusting timing chemotherapy. Dose-dense regimens are tested, there interest so-called metronomic chemotherapy very low doses given frequent schedule, resulting reduced toxicity reflect an antiangiogenic mode action. Finally, possibility vaccine continues intrigue excite physicians patients alike, promise enlisting body's own immune system seek out destroy cells and/or prevent future disease. It important surgeons stay aware all developments care their true oncologists rather than merely technicians. Cancer 2007. © 2007 American Society.