The Breast : official journal of the European Society of Mastology
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Women are conventionally advised to stop tamoxifen before attempting pregnancy. The risks of congenital malformations or late teratogenic manifestations in adulthood are unknown. Following an informed discussion about the uncertainties of tamoxifen exposure on pregnancy women should be offered the choice whether to continue or stop tamoxifen before attempting pregnancy. An unexpected pregnancy in a women taking tamoxifen could continue if the pregnant woman accepts the possibility of a teratogenic effect that tamoxifen could have on the fetus.
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Adjuvant tamoxifen is still considered standard care for postmenopausal women with early stage hormone receptor-positive breast cancer. However, efficacy and safety of tamoxifen are limited by its partially estrogenic properties. ⋯ Results of several adjuvant aromatase inhibitor trials have been published and strongly indicate that efficacy may be increased compared with tamoxifen alone. This review will examine the published data, discuss ongoing trials, and address the question of how to best integrate the aromatase inhibitors into adjuvant treatment.
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The aim of this study was to investigate whether skin-sparing mastectomy (SSM), which is gaining increasing importance and gives well-accepted cosmetic results, provides adequate treatment of the patients' oncologic disease. From 1995 to 2003, 60 patients diagnosed with invasive breast cancer were treated with SSM and complete axillary dissection. All patients underwent immediate breast reconstruction after primary surgery. ⋯ SSM followed by immediate breast reconstruction is an alternative to modified radical mastectomy in a subset of patients with invasive breast cancer. The risk of local recurrence is low and is associated with such factors as tumor stage, poor tumor differentiation, and node-positive disease. This procedure does not increase the risk of distant metastases, which is comparable to that after other surgical approaches.