By J. Michael Dixon
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Additional resources for ABC of Breast Diseases, 3rd edition (ABC Series)
Complete excision of all invasive and in situ disease is essential. 6) times more likely if margins are involved. Wider margins (beyond 1 mm) do not reduce local recurrence further but do adversely affect cosmetic outcomes. Neither atypical ductal hyperplasia nor lobular carcinoma at the margins increases local recurrence and re-excision based on their presence at a resection margin is not necessary. The risk of local recurrence falls with increasing age: young patients (Ͻ35) are two to three times more likely to develop local recurrence than older patients.
Ionising radiation also increases risk later in life but by considerably less. 3 Diethylstilbestrol 2 Cumulative risk of cancer (%) Certain mutations occur at high frequency in defined populations. For instance, some 2% of Ashkenazim Jewish women carry BRCA1 185 del AG (deletion of two base pairs in position 185), BRCA1 5382 ins C (insertion of an extra base pair at position 5382), or BRCA 6174 del T (deletion of a single base pair at position 6174), while BRCA2 999 del 5 (deletion of five base pairs at position 999) accounts for about half of all familial breast cancer in Iceland.
London: Saunders, 2000. ● Dixon JM, Bundred NJ. Management of disorders of the ductal system. In: Harris JR, Lippman ME, Morrow M, Hellman S, eds. Diseases of the breast. Philadelphia: Lippincott Williams and Wilkins, 2004:47–56. ● Taylor GB, Paviour SD, Musaad S, Jones WO, Holland DJ. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 2003;35:109–19. ● 23 5 Breast cancer—epidemiology, risk factors, and genetics K McPherson, CM Steel, JM Dixon With over a million new cases in the world each year, breast cancer is the most common malignancy in women and comprises 18% of all female cancers.
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