Atlas of Breast Surgery

New developments in the surgical management of breast disease surge daily. New techniques for tumor resection, reconstructive survery, lymph node assessment and cosmetic surgery are surfacing due to new demands in the market. The treatments are aimed at those patients diagnosed with breast disease who need quality medical treatment and require equally pleasing aesthetic results. This is an international text that outlines the management of both the malignant and benign diseases of the breast. High quality illustrations accompany the text to highlight the key aspects of surgical techniques. An emphasis on the techniques that provide good cosmetic outcomes is the underlying theme of this text.
Written for:
Clinicians, researchers, practitioners

Table of Contents:

Chapter 1
Historical Overview of Breast Surgery

Chapter 2
Anatomy
2.1 Surface Anatomy of the Breast . . . . . 7
2.2 Breast Development . . . . . . . . . . . 8
2.3 Organization of the Ductal-Lobular
System and its Diseases . . . . . . . . . 10
2.4 Blood Supply of the Breast . . . . . . . 11
2.5 Anatomy of the Axilla . . . . . . . . . . 12
2.6 Latissimus Dorsi Muscle
and Related Muscles . . . . . . . . . . 13
2.7 Anterior View of Latissimus Dorsi
Muscle and Blood Supply
(Pectoralis Major Muscle Removed) . . 14
2.8 Anterior Abdominal Wall
and Blood Supply . . . . . . . . . . . . 15

Chapter 3
Diagnostic Procedures
3.1 Fine Needle Aspiration . . . . . . . . . 19
3.2 Core Needle Biopsy . . . . . . . . . . . 22
3.3 Overview of Biopsy Techniques . . . . 30
3.4 Needle-Localized Biopsy . . . . . . . . 33
3.5 Microductectomy . . . . . . . . . . . . 37
3.6 Subareolar Dissection . . . . . . . . . . 39
3.7 Mammary Ductoscopy . . . . . . . . . 40

Chapter 4
Surgery for Benign Breast Diseases
4.1 Cyst Aspiration . . . . . . . . . . . . . 43
4.2 Excision of Intraductal Papilloma . . . 45
4.3 Excision of Giant Fibroadenoma . . . . 46
4.4 Drainage of a Breast Abscess . . . . . . 47
4.5 Surgical Management of Gynecomastia 50

Chapter 5
Biopsy Procedures
5.1 Incision Lines for Excisional Biopsy . . 55
5.2 Variants of Incisions and Extent
of Breast Cancer Surgery . . . . . . . . 57
5.3 Lumpectomy (Wide Excision) . . . . . 59
5.4 Specimen Management
for the Pathologist . . . . . . . . . . . 60

Chapter 6
Surgery for Breast Carcinoma
6.1 Modified Radical Mastectomy . . . . . 61
6.2 Simple Mastectomy . . . . . . . . . . . 67
6.3 Breast-Conserving Cancer Surgery . . . 67
6.4 Axillary Lymph Node Dissection
(Level I, Level II, Level III) . . . . . . . 78
6.5 Sentinel Lymph Node Biopsy . . . . . . 81
6.6 Internal Mammary Node Biopsy . . . . 83
6.7 Venous Access for Chemotherapy . . . 83
References . . . . . . . . . . . . . . . . 84

Chapter 7
Plastic and Reconstructive Breast Surgery
7.1 Immediate and Delayed
Breast Reconstruction . . . . . . . . . 85
7.2 Placement of Definitive Prosthesis . . . 85
7.3 Breast Reconstruction with Expander . 91
7.4 Hypothesis to Explain Capsular
Contracture . . . . . . . . . . . . . . . 93
7.5 Suspension Technique
(Advancement Abdominal Flap) . . . . 94
7.6 Latissimus Dorsi Flap . . . . . . . . . . 96
7.7 Total Breast Reconstruction
with a Totally De-epithelialized
Latissimus Dorsi Flap
and Autologous Latissimus Flap . . . . 99
7.8 Latissimus Dorsi Flap
to Repair Glandular Defects
Following Quadrantectomy . . . . . . . 100
7.9 Pedicle TRAM Flap Reconstruction . . 101
7.9.1 Abdominal Closure . . . . . . . . . . . 102
7.9.2 Free Flaps . . . . . . . . . . . . . . . . 103
7.10 Nipple Reconstruction . . . . . . . . . 109
7.11 Thoracoepigastric Cutaneous Flap
for Large Thoracic Wall Defects . . . . 111
7.12 Partial (or Total) Reconstruction
with Omental Flaps . . . . . . . . . . . 112
7.13 Reduction Mammoplasty . . . . . . . . 113
7.14 Reduction Mammoplasty:
Vertical Technique (Lejour) . . . . . . . 115
7.15 Reduction Mammoplasty:
Inferior Pedicle Technique . . . . . . . 117
7.16 Round Block Technique
of Reduction Mammoplasty . . . . . . 119
7.17 Breast Ptosis Classification . . . . . . . 121
7.18 Mastopexy . . . . . . . . . . . . . . . 122
7.19 Round Block Technique for Mastopexy . 122
7.20 Mastopexy: Oblique Technique
(DuFourmentel) . . . . . . . . . . . . 125
7.21 Augmentation Mammoplasty . . . . . . 126
7.22 Nipple Plasty for Inverted Nipple . . . . 129
References . . . . . . . . . . . . . . . . 130
Subject Index . . . . . . . . . . . . . . . . . 131
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