DOCSLIB.ORG

NCCN Guidelines for Patients Invasive Breast Cancer

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

our Pleaseonline surveycomplete at NCCN.org/patients/survey NCCN GUIDELINES FOR PATIENTS® 2020 Breast Cancer Invasive Presented with support from: Available online at NCCN.org/patients Ü Invasive Breast Cancer It's easy to get lost in the cancer world Let Ü NCCN Guidelines for Patients® be your guide 9 Step-by-step guides to the cancer care options likely to have the best results 9 Based on treatment guidelines used by health care providers worldwide 9 Designed to help you discuss cancer treatment with your doctors NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 1 About NCCN Guidelines for Patients® are developed by the National Comprehensive Cancer Network® (NCCN®) NCCN Clinical Practice ® Ü Ü NCCN Guidelines NCCN Guidelines in Oncology ® ® for Patients (NCCN Guidelines ) 9 An alliance of leading 9 Developed by doctors from 9 Present information from the cancer centers across the NCCN cancer centers using NCCN Guidelines in an easy- United States devoted to the latest research and years to-learn format patient care, research, and of experience 9 For people with cancer and education 9 For providers of cancer care those who support them all over the world 9 Explain the cancer care Cancer centers options likely to have the that are part of NCCN: 9 Expert recommendations for best results NCCN.org/cancercenters cancer screening, diagnosis, and treatment Free online at Free online at NCCN.org/patientguidelines NCCN.org/guidelines and supported by funding from NCCN Foundation® These NCCN Guidelines for Patients® are based on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer (Version 3.2020, March 6, 2020). © 2020 National Comprehensive Cancer Network, Inc. All rights reserved. NCCN Foundation® seeks to support the millions of patients and their families NCCN Guidelines for Patients® and illustrations herein may not be reproduced affected by a cancer diagnosis by funding and distributing NCCN Guidelines for in any form for any purpose without the express written permission of NCCN. No Patients®. NCCN Foundation is also committed to advancing cancer treatment one, including doctors or patients, may use the NCCN Guidelines for Patients for by funding the nation’s promising doctors at the center of innovation in cancer any commercial purpose and may not claim, represent, or imply that the NCCN research. For more details and the full library of patient and caregiver resources, Guidelines for Patients that have been modified in any manner are derived visit NCCN.org/patients. from, based on, related to, or arise out of the NCCN Guidelines for Patients. The NCCN Guidelines are a work in progress that may be redefined as often National Comprehensive Cancer Network® (NCCN®) / NCCN Foundation® as new significant data become available. NCCN makes no warranties of any 3025 Chemical Road, Suite 100 kind whatsoever regarding its content, use, or application and disclaims any Plymouth Meeting, PA 19462 responsibility for its application or use in any way. 215.690.0300 NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 2 Supporters Endorsed by Breast Cancer Alliance FORCE: Facing Our Risk of Cancer Receiving a cancer diagnosis can be overwhelming, Empowered both for the patient and their family. We support As the nation’s leading organization serving the the NCCN Guidelines for Patients: Invasive Breast hereditary cancer community, FORCE is pleased to Cancer with the knowledge that these tools will endorse the NCCN Guidelines for Patients: Invasive help to equip patients with many of the educational Breast Cancer. This guide provides valuable, resources, and answers to questions, they may seek. evidence-based, expert reviewed information on the breastcanceralliance.org standard of care, empowering patients to make informed decisions about their treatment. facingourrisk.org Breastcancer.org Breastcancer.org is a leading resource for people to Sharsheret make sense of the complex medical and personal Sharsheret is proud to endorse this important resource, information about breast health and breast cancer. Our the NCCN Guidelines for Patients: Invasive Breast mission is to engage, educate, and empower people Cancer. With this critical tool in hand, women nationwide with expert information and our dynamic peer support have the knowledge they need to partner with their community to help everyone make the best decisions for healthcare team to navigate the often complicated world their lives. breastcancer.org of breast cancer care and make informed treatment decisions. sharsheret.org DiepCFoundation DiepCFoundation applauds the National Comprehensive Cancer Network (NCCN) for their ongoing work in the development of Patient Guidelines. We endorse the NCCN Guidelines for Patients: Invasive Breast Cancer for patients seeking information about all options for breast reconstruction after cancer. The Principles of Breast Reconstruction Following Surgery in the NCCN Guidelines directly aligns with the mission of the Foundation to educate and empower more patients with the information needed to make an informed decision about breast reconstruction after surgical treatment for breast cancer. diepcfoundation.org With generous support from • Benjamin Anderson, MD, in honor of Joan McClure • Kristina Griffin • Patricia Andrews • Kate Townsend To make a gift or learn more, please visit NCCNFoundation.org/donate or e-mail [email protected]. NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 3 NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 4 Invasive Breast Cancer Contents 6 Breast cancer basics 14 Testing for breast cancer 28 Treatment options 41 Breast reconstruction 44 Stage 1, 2, and 3A 59 Stage 3 71 Recurrence 75 Inflammatory breast cancer 85 Making treatment decisions 94 Words to know 98 NCCN Contributors 99 NCCN Cancer Centers 100 Index NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 5 1 Breast cancer basics 7 The breast 8 Breast cancer 8 How breast cancer spreads 9 Cancer stages 11 Invasive breast cancer stages 13 Review NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 6 1 Breast cancer basics The breast Breast cancer starts in the cells of the Breast tissue contains glands that can make breast. Invasive breast cancer is cancer milk. These milk glands are called lobules. that has spread from the milk ducts or Lobules look like tiny clusters of grapes. Small milk glands into the breast tissue or tubes called ducts connect the lobules to the nearby lymph nodes. nipple. The ring of darker breast skin is called the areola. The raised tip within the areola is called The breast the nipple. The nipple-areola complex is a term that refers to both parts. The breast is an organ and a gland found on Lymph is a clear fluid that gives cells water and the chest. The breast is made of milk ducts, fat, food. It also helps to fight germs. Lymph drains nerves, lymph and blood vessels, ligaments, from breast tissue into lymph vessels and and other connective tissue. Behind the breast travels to lymph nodes near your armpit (axilla). is the pectoral muscle and ribs. Muscle and Nodes near the armpit are called axillary lymph ligaments help hold the breast in place. nodes (ALNs). The breast The breast is a glandular organ made Lymph nodes up of milk ducts, Lobules fat, nerves, blood Suspensory Adipose tissue and lymph vessels, ligaments ligaments, and other Lobe Nipple Areola connective tissue. Skin Alveoli Lactiferous duct NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 7 1 Breast cancercancer basics basics Breast cancercancer | How breast cancer spreads Breast cancer How breast cancer spreads Breast cancer starts in the cells of the breast. Cancer cells don’t behave like normal cells. Almost all breast cancers are carcinomas. Cancer cells differ from normal cells in the Carcinomas are cancers that start in the cells following ways. that line the inner or outer surfaces of the body. Primary tumor There is more than one type of breast Over time, cancer cells form a mass called a carcinoma. primary tumor. Ductal breast cancer starts in the cells that line the milk ducts. Milk ducts are Invasive thin tubes that carry milk from the lobules Cancer cells can grow into surrounding tissues. of the breast to the nipple. It is the most Invasive breast cancer is breast cancer that has common type of breast cancer. spread from the milk ducts or lobules into the breast tissue or nearby lymph nodes. Lobular breast cancer starts in the lobules (milk glands) of the breast. Metastasis Anyone can have breast cancer, including men. Unlike normal cells, cancer cells can spread Although there are some differences between and form tumors in other parts of the body. men and women, treatment is very similar. Cancer that has spread is called a metastasis. In this process, cancer cells break away from the first (primary) tumor and travel through blood or lymph vessels to distant sites. Once in other sites, cancer cells may form secondary tumors. Cancer that has spread to a nearby body part such as the axillary lymph nodes is called a local metastasis. It might be referred to as local/regional disease or locally advanced. Cancer that has spread to a body part far from the primary tumor is called a distant metastasis. Breast cancer can metastasize to the bones, lungs, liver, spine, or brain. Breast cancer that has metastasized to other parts of the body is still called breast cancer. NCCN Guidelines for Patients®: Invasive Breast Cancer, 2020 8 1 Breast cancer basics Cancer stages Cancer stages Progesterone receptor (PR) status: Does the cancer have the protein called a A cancer stage is a rating of the cancer based progesterone receptor? on test results. The American Joint Committee Human epidermal growth factor on Cancer (AJCC) created this to determine receptor 2 (HER2) status: Does the how much cancer is in your body, where it is cancer make too much of a protein called located, and what subtype you have.
Recommended publications
  • Breast Cancer Screening HEDIS Tip Sheet

    Breast Cancer Screening HEDIS Tip Sheet

    HEDIS® Tip Sheet Effectiveness of Care Measure Breast Cancer Screening Breast cancer is the most common type of cancer, and the second leading cause of cancer-related deaths among women in the United States. Approximately 237,000 cases of breast cancer are diagnosed in women, and about 41,000 women die each year of breast cancer.1 Mammography is an effective screening tool for early detection of breast cancer and reduction of breast cancer mortality. California Health & Wellness want to help your practice increase Healthcare Effectiveness Data and Information Set (HEDIS®) rates. This tip sheet outlines key details of the Breast Cancer Screening (BCS) measure, its codes and guidance for documentation. Measure Women ages 50–74 who had a mammogram to screen for breast cancer in the past two years.2 Exclusions: • Patients who meet the following – A unilateral mastectomy criteria anytime during the without a modifier and measurement year: a left mastectomy with – Medicare patients ages 66 and service dates 14 days or older enrolled in an institutional more apart. special needs plans (I-SNP) or – A unilateral mastectomy living long-term in an institution. without a modifier and a – Patients ages 66 and older with right mastectomy with service frailty and advanced illness. dates 14 days or more apart. – Patients in hospice. – Absence of the left breast and absence of the right breast on the • Patients with bilateral mastectomy. same or different dates of service. Any of the following meet the criteria – Both of the following (on the same for bilateral mastectomy: or different dates of service): – Bilateral mastectomy or history.
  • Primary Screening for Breast Cancer with Conventional Mammography: Clinical Summary

    Primary Screening for Breast Cancer with Conventional Mammography: Clinical Summary

    Primary Screening for Breast Cancer With Conventional Mammography: Clinical Summary Population Women aged 40 to 49 y Women aged 50 to 74 y Women aged ≥75 y The decision to start screening should be No recommendation. Recommendation Screen every 2 years. an individual one. Grade: I statement Grade: B Grade: C (insufficient evidence) These recommendations apply to asymptomatic women aged ≥40 y who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation Risk Assessment (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. Increasing age is the most important risk factor for most women. Conventional digital mammography has essentially replaced film mammography as the primary method for breast cancer screening Screening Tests in the United States. Conventional digital screening mammography has about the same diagnostic accuracy as film overall, although digital screening seems to have comparatively higher sensitivity but the same or lower specificity in women age <50 y. For women who are at average risk for breast cancer, most of the benefit of mammography results from biennial screening during Starting and ages 50 to 74 y. While screening mammography in women aged 40 to 49 y may reduce the risk for breast cancer death, the Stopping Ages number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger. The balance of benefits and harms is likely to improve as women move from their early to late 40s.
  • Breast Reconstruction with Expanders and Implants

    Breast Reconstruction with Expanders and Implants

    Evidence-Based Clinical Practice Guideline: Breast Reconstruction with Expanders and Implants INTRODUCTION Disclaimer Evidence-based guidelines are strategies for patient management, The American Cancer Society estimates that nearly 230,000 American developed to assist physicians in clinical decision making. This women were diagnosed with invasive breast cancer in 2011.1 Many of guideline was developed through a comprehensive review of the these individuals will require mastectomy and total reconstruction of scientific literature and consideration of relevant clinical experience, the breast. The diagnosis and subsequent process can create signifi- and describes a range of generally acceptable approaches to diagnosis, cant confusion and distress for the affected persons and their families management, or prevention of specific diseases or conditions. This and, consequently, surgical treatment and reconstructive procedures guideline attempts to define principles of practice that should are of utmost importance in the breast cancer care continuum. In generally meet the needs of most patients in most circumstances. 2011, the American Society of Plastic Surgeons® (ASPS) reported an increase in the rate of breast reconstructions, citing nearly 100,000 However, this guideline should not be construed as a rule, nor procedures, of which the majority employed expanders/implants.2 should it be deemed inclusive of all proper methods of care The 3% increase in reconstructions over the course of just one year or exclusive of other methods of care reasonably directed at highlights the significance of maintaining patient safety and obtaining the appropriate results. It is anticipated that it will be optimizing surgical outcomes. necessary to approach some patients’ needs in different ways.
  • Updates in Assessment of the Breast After Neoadjuvant Treatment

    Updates in Assessment of the Breast After Neoadjuvant Treatment

    Updates in Assessment of The Breast After Neoadjuvant Treatment Laila Khazai 3/3/18 AJCC, 8th Edition AJCC • Pathologic Prognostic Stage is not applicable for patients who receive neoadjuvant therapy. • Pathologic staging includes all data used for clinical staging, plus data from surgical resection. • Information recorded should include: – Clinical Prognostic Stage. – The category information for either clinical (ycT and ycN) response to therapy if surgery is not performed, or pathologic (ypT and ypN) if surgery is performed. – Degree of response (complete, partial, none). AJCC • Post -treatment size should be estimated based on the best combination of imaging, gross, and microscopic histological findings. • The ypT is determined by measuring the largest single focus of residual invasive tumor, with a modifier (m) indicating multiple foci of residual tumor. • This measurement does not include areas of fibrosis within the tumor bed. • When the only residual cancer intravascular or intralymphatic (LVI), the yPT0 category is assigned, but it is not classified as complete pathologic response. A formal system (i.e. RCB, Miller-Payne, Chevalier, …) may be offered in the report. Otherwise, description of the distance over which tumor foci extend, the number of tumor foci present, or the number of tumor slides/blocks in which tumor appears might be offered. AJCC • The ypN categories are the same as those used for pN. • Only the largest contiguous focus of residual tumor is used for classification (treatment associated fibrosis is not included). • Inclusion of additional information such as distance over which tumor foci extend and the number of tumor foci present, may assist the clinician in estimating the extent of residual disease.
  • Surgical Options for Breast Cancer

    Surgical Options for Breast Cancer

    The Breast Center Smilow Cancer Hospital 20 York Street, North Pavilion New Haven, CT 06510 Phone: (203) 200-2328 Fax: (203) 200-2075 SURGICAL OPTIONS There are a number of surgical procedures available today for the treatment of breast cancer. You will likely have a choice and will need to make your own decision, in consultation with your specific surgeon, about the best option for you. We offer you a choice because the research on the treatment of breast cancer has clearly shown that the cure and survival rates are the same regardless of what you choose. The choices can be divided into breast conserving options (i.e. lumpectomy or partial mastectomy) or breast removing options (mastectomy). A procedure to evaluate your armpit (axillary) lymph nodes will likely occur at the same time as your breast surgery. This is done to help determine the likelihood that cells from your breast cancer have left the breast and spread (metastasized) to another more dangerous location. This information will be used to help decide about your need for chemotherapy or hormone blocking drugs after surgery. PARTIAL MASTECTOMY (LUMPECTOMY) A partial mastectomy involves removing the cancer from your breast with a rim, or margin, of normal breast tissue. This allows the healthy noncancerous part of your breast to be preserved, and usually will not alter the sensation of the nipple. The benefit of this surgical choice is that it often preserves the cosmetics of the breast. Your surgeon will make a decision about the volume of tissue that needs removal in order to maximize the chance of clear margins as confirmed by our pathologist.
  • Breast Cancer Treatment What You Should Know Ta Bl E of C Onte Nts

    Breast Cancer Treatment What You Should Know Ta Bl E of C Onte Nts

    Breast Cancer Treatment What You Should Know Ta bl e of C onte nts 1 Introduction . 1 2 Taking Care of Yourself After Your Breast Cancer Diagnosis . 3 3 Working with Your Doctor or Health Care Provider . 5 4 What Are the Stages of Breast Cancer? . 7 5 Your Treatment Options . 11 6 Breast Reconstruction . 21 7 Will Insurance Pay for Surgery? . 25 8 If You Don’t Have Health Insurance . 26 9 Life After Breast Cancer Treatment . 27 10 Questions to Ask Your Health Care Team . 29 11 Breast Cancer Hotlines, Support Groups, and Other Resources . 33 12 Definitions . 35 13 Notes . 39 1 Introducti on You are not alone. There are over three million breast cancer survivors living in the United States. Great improvements have been made in breast cancer treatment over the past 20 years. People with breast cancer are living longer and healthier lives than ever before and many new breast cancer treatments have fewer side effects. The New York State Department of Health is providing this information to help you understand your treatment choices. Here are ways you can use this information: • Ask a friend or someone on your health care team to read this information along with you, or have them read it and talk about it with you when you feel ready. • Read this information in sections rather than all at once. For example, if you have just been diagnosed with breast cancer, you may only want to read Sections 1-4 for now. Sections 5-8 may be helpful while you are choosing your treatment options, and Section 9 may be helpful to read as you are finishing treatment.
  • Procedure: Mastectomy Instructions Surgery Information: 1

    Procedure: Mastectomy Instructions Surgery Information: 1

    Procedure: Mastectomy Instructions Surgery Information: 1. Please stop all vitamins, supplements, and herbal medications one week before surgery, your surgeon will review any other medications that need to be stopped before surgery 2. Surgery will take about 2.5 hours 3. Surgery will be at Aspirus Wausau Hospital 4. You will have General Anesthesia 5. You will likely go home 24 hours after your surgery, but may stay longer if needed 6. If you are sensitive to tape, please tell your check-in nurse on your day of surgery 7. You will need an appointment with us about 1 week after your surgery for an incision check unless you had reconstruction (then your post-operative appt. will be with your Plastic Surgeon) Follow up appt:__________________ 8. We will call you typically within 3 business days with final pathology results 9. Please remember to wear the binder the you were given at all times (unless showering) until two weeks after your last drain is removed– the binder can be washed and hung to dry if needed. If your binder is itchy you can try wearing a T-shirt/tank top underneath or use an ACE wrap for gentle compression. AVOID more than slight pressure. Restrictions: 1. No lifting more than 15lbs. for 2 weeks after the last drain is removed 2. You will be given arm exercises by occupational therapy before you leave the hospital. It is important that you follow the instructions you are given 3. No pushing, pulling, or stretching overhead for 2 weeks after the last drain is removed.
  • The Updated AJCC/TNM Staging System (8Th Edition) for Oral Tongue Cancer

    The Updated AJCC/TNM Staging System (8Th Edition) for Oral Tongue Cancer

    166 Editorial The updated AJCC/TNM staging system (8th edition) for oral tongue cancer Kyubo Kim, Dong Jin Lee Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Seoul, South Korea Correspondence to: Dong Jin Lee, MD, PhD. 1 Singil-ro, Yeongdeungpo-gu, Seoul 150-950, South Korea. Email: [email protected]. Comment on: Almangush A, Mäkitie AA, Mäkinen LK, et al. Small oral tongue cancers (≤ 4 cm in diameter) with clinically negative neck: from the 7th to the 8th edition of the American Joint Committee on Cancer. Virchows Arch 2018;473:481-7. Submitted Dec 22, 2018. Accepted for publication Dec 28, 2018. doi: 10.21037/tcr.2019.01.02 View this article at: http://dx.doi.org/10.21037/tcr.2019.01.02 An increasing amount of literature shows solid evidence that updated classification system and the applicability of DOI as the depth of invasion (DOI) of oral cavity squamous cell a predictor of clinical behavior for early-stage OTSCC. carcinoma is an independent predictor for occult metastasis, The AJCC 8th edition employs a cut-off value of 5 mm recurrence, and survival (1-3). Furthermore, the DOI of the DOI for upstaging from stage T1 to T2 and 10 mm for primary tumor has been a major criterion when deciding to upstaging to T3. This may be questionable as it has been perform elective neck dissection on oral cavity squamous shown that an invasion depth of more than 4 mm increases cell carcinoma patients since as early as the mid-1990s (4). the risk of locoregional metastasis and is associated with a A cut-off value of 4 mm has conventionally been used poor prognosis (9-11), but with the new staging system, a when determining the need for elective neck dissection, large number of invasive tumors in which the DOI is less based on a study by Kligerman et al.
  • Oncology 101 Dictionary

    Oncology 101 Dictionary

    ONCOLOGY 101 DICTIONARY ACUTE: Symptoms or signs that begin and worsen quickly; not chronic. Example: James experienced acute vomiting after receiving his cancer treatments. ADENOCARCINOMA: Cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, or other fluids. Most cancers of the breast, pancreas, lung, prostate, and colon are adenocarcinomas. Example: The vast majority of rectal cancers are adenocarcinomas. ADENOMA: A tumor that is not cancer. It starts in gland-like cells of the epithelial tissue (thin layer of tissue that covers organs, glands, and other structures within the body). Example: Liver adenomas are rare but can be a cause of abdominal pain. ADJUVANT: Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy. Example: The decision to use adjuvant therapy often depends on cancer staging at diagnosis and risk factors of recurrence. BENIGN: Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant. Example: Mary was relieved when her doctor said the mole on her skin was benign and did not require any further intervention. BIOMARKER TESTING: A group of tests that may be ordered to look for genetic alterations for which there are specific therapies available. The test results may identify certain cancer cells that can be treated with targeted therapies. May also be referred to as genetic testing, molecular testing, molecular profiling, or mutation testing.
  • Therapeutic Mammaplasty Information for Patients the Aim of This Booklet Is to Give You Some General Information About Your Surgery

    Therapeutic Mammaplasty Information for Patients the Aim of This Booklet Is to Give You Some General Information About Your Surgery

    Oxford University Hospitals NHS Trust Therapeutic mammaplasty Information for patients The aim of this booklet is to give you some general information about your surgery. If you have any questions or concerns after reading it please discuss them with your breast care nurse practitioner or a member of staff at the Jane Ashley Centre. Telephone numbers are given at the end of this booklet. Author: Miss P.G.Roy, Consultant Oncoplastic Breast Surgeon Oxford University Hospitals NHS Trust Oxford OX3 9DU page 2 Therapeutic mammaplasty This operation involves combining a wide local excision (also known as a lumpectomy) with a breast reduction technique resulting in a smaller, uplifted and better shaped breast. This means that the lump can be removed with a wide rim of healthy tissue. The nipple and areola are preserved with their intact blood supply and the remaining breast tissue is repositioned to allow reshaping of the breast. The scars are either in the shape of a lollipop or an anchor (as shown below). You may have a drain placed in the wound to remove excess fluid; this is usually left in for 24 hours. This procedure can be carried out on one or both of your breasts, as discussed with your surgeon. Vertical mammaplasty Lollipop scar Wise pattern Anchor shaped scar mammaplasty page 3 Your nipple is moved to a new position to suit your new breast shape and size but it may end up in a position different to your wishes. The surgeon will try to achieve a mutually agreed breast size whilst performing the operation; however a cup size cannot be guaranteed and there are likely to be further significant changes to your breast after radiotherapy.
  • Sentinel Lymph Node Mapping in Endometrial Cancer: a Comprehensive Review

    Sentinel Lymph Node Mapping in Endometrial Cancer: a Comprehensive Review

    REVIEW published: 29 June 2021 doi: 10.3389/fonc.2021.701758 Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review Lirong Zhai 1, Xiwen Zhang 2, Manhua Cui 2 and Jianliu Wang 1* 1 Department of Gynecology and Obstetrics, Peking University People’s Hospital, Beijing, China, 2 Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, China Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic Edited by: metastasis of the primary malignant tumor through the regional lymphatic drainage Fabio Martinelli, pathway and can indicate the involvement of lymph nodes across the drainage area. Istituto Nazionale dei Tumori (IRCCS), Italy Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative Reviewed by: predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node Benedetta Guani, mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the Centre Hospitalier Universitaire ’ Vaudois (CHUV), Switzerland patient s progression-free survival (PFS) and overall survival (OS) with low operative Giulio Sozzi, complications.
  • Cancer Treatment and Survivorship Facts & Figures 2019-2021

    Cancer Treatment and Survivorship Facts & Figures 2019-2021

    Cancer Treatment & Survivorship Facts & Figures 2019-2021 Estimated Numbers of Cancer Survivors by State as of January 1, 2019 WA 386,540 NH MT VT 84,080 ME ND 95,540 59,970 38,430 34,360 OR MN 213,620 300,980 MA ID 434,230 77,860 SD WI NY 42,810 313,370 1,105,550 WY MI 33,310 RI 570,760 67,900 IA PA NE CT 243,410 NV 185,720 771,120 108,500 OH 132,950 NJ 543,190 UT IL IN 581,350 115,840 651,810 296,940 DE 55,460 CA CO WV 225,470 1,888,480 KS 117,070 VA MO MD 275,420 151,950 408,060 300,200 KY 254,780 DC 18,750 NC TN 470,120 AZ OK 326,530 NM 207,260 AR 392,530 111,620 SC 143,320 280,890 GA AL MS 446,900 135,260 244,320 TX 1,140,170 LA 232,100 AK 36,550 FL 1,482,090 US 16,920,370 HI 84,960 States estimates do not sum to US total due to rounding. Source: Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute. Contents Introduction 1 Long-term Survivorship 24 Who Are Cancer Survivors? 1 Quality of Life 24 How Many People Have a History of Cancer? 2 Financial Hardship among Cancer Survivors 26 Cancer Treatment and Common Side Effects 4 Regaining and Improving Health through Healthy Behaviors 26 Cancer Survival and Access to Care 5 Concerns of Caregivers and Families 28 Selected Cancers 6 The Future of Cancer Survivorship in Breast (Female) 6 the United States 28 Cancers in Children and Adolescents 9 The American Cancer Society 30 Colon and Rectum 10 How the American Cancer Society Saves Lives 30 Leukemia and Lymphoma 12 Research 34 Lung and Bronchus 15 Advocacy 34 Melanoma of the Skin 16 Prostate 16 Sources of Statistics 36 Testis 17 References 37 Thyroid 19 Acknowledgments 45 Urinary Bladder 19 Uterine Corpus 21 Navigating the Cancer Experience: Treatment and Supportive Care 22 Making Decisions about Cancer Care 22 Cancer Rehabilitation 22 Psychosocial Care 23 Palliative Care 23 Transitioning to Long-term Survivorship 23 This publication attempts to summarize current scientific information about Global Headquarters: American Cancer Society Inc.