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SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES
Acta medico-historica Adriatica : AMHA, 19 (2021), 1; 125-136. urn:nbn:hr:184:271943
Grebić, Damir; Pirjavec, Aleksandra; Kustić, Domagoj; Klarica Gembić, Tihana

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Grebić, D., Pirjavec, A., Kustić, D. & Klarica Gembić, T. (2021). SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES. Acta medico-historica Adriatica : AMHA, 19. (1), 125-136. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:271943

Grebić, Damir, et al. "SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES." Acta medico-historica Adriatica : AMHA, vol. 19, no. 1, 2021, pp. 125-136. https://urn.nsk.hr/urn:nbn:hr:184:271943

Grebić, Damir, Aleksandra Pirjavec, Domagoj Kustić and Tihana Klarica Gembić. "SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES." Acta medico-historica Adriatica : AMHA 19, no. 1 (2021): 125-136. https://urn.nsk.hr/urn:nbn:hr:184:271943

Grebić, D., et al. (2021) 'SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES', Acta medico-historica Adriatica : AMHA, 19(1), pp. 125-136. Available at: https://urn.nsk.hr/urn:nbn:hr:184:271943 (Accessed 11 December 2024)

Grebić D, Pirjavec A, Kustić D, Klarica Gembić T. SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES. Acta medico-historica Adriatica : AMHA [Internet]. 2021 [cited 2024 December 11];19(1):125-136. Available at: https://urn.nsk.hr/urn:nbn:hr:184:271943

D. Grebić, A. Pirjavec, D. Kustić and T. Klarica Gembić, "SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES", Acta medico-historica Adriatica : AMHA, vol. 19, no. 1, pp. 125-136, 2021. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:271943. [Accessed: 11 December 2024]

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Metadata
Title (english)SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES
Title (croatian)KIRURŠKO LIJEČENJE KARCINOMA DOJKE I AKSILARNIH METASTAZA: POVIJESNA PERSPEKTIVA
AuthorDamir Grebić
AuthorAleksandra Pirjavec
AuthorDomagoj Kustić
AuthorTihana Klarica Gembić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Surgery)
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Nuclear Medicine)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Basic Medical Sciences
History of Medicine and the Biomedical Sciences
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Abstract (english)
Breast cancer (BC) is the most common malignancy to affect females. The first suggestions of BC and its treatment date back to Ancient Egypt, 1500-1600 B.C. Throughout history, the management of BC has evolved from extensive radical mastectomy towards less invasive treatments. Radical mastectomy was introduced by W.S. Halsted in 1894, involving the resection of the breast, regional lymph nodes, pectoralis major and minor. Despite its mutilating effect, it had been the main surgical approach to BC patients until 1948, when Patey and Dyson proposed its modified form that conserved pectoralis major and minor and the level III of axillary lymph nodes. The latter was associated with less postoperative morbidity and improved quality of life. The idea of limited breast tissue resection was introduced in the 1970s by Umberto Veronesi and led to further minimizations of surgery in BC patients until breast conservation became the standard of care for early-stage disease. In the 1990s, intraoperative lymphatic mapping and the concept of sentinel lymph node (SLN) biopsy (SLNB) have been developed. SLNB has replaced axillary lymph node dissection (ALND) to be the standard procedure for axillary staging in patients with clinically node-negative BC. Many women have since been spared ALND, including those with negative SLNB or with SLNs involved with micrometastases (0.2-2 mm in size). In the last decade, evidence gathered from new clinical trials suggests that ALND may be safely omitted even in BC patients with 1 or 2 positive SLNs if adjuvant radiotherapy is delivered. 
Abstract (croatian)
Karcinom dojke najčešći je maligni tumor u žena. Prvi zapisi o karcinomu dojke i njegovu liječenje datiraju iz drevnog Egipta 1500 - 1600 godina pr. n. e. Terapijski pristup bolesti mijenjao se kroz povijest te je nekadašnji invazivni, kao npr. radikal-na mastektomija, s vremenom zamijenjen manje invazivnim kirurškim metodama. W. S. Halsted 1894. predstavlja metodu radikalne mastektomije koja uključuje potpunu resekciju dojke, regionalnih limfnih čvorova te velikog i malog pektoralnog mišića. Unatoč čestim postoperacijskim komplikacijama, zauzimala je glavno mjesto među kirurškim moda-litetima liječenja karcinoma dojke sve do 1948. kada su Patey and Dyson predstavili modifici-ranu radikalnu mastektomiju kojom su se, za razliku od radikalne, sačuvali pektoralni mišići te pazušni limfni čvorovi lože III, a postoperacijske su komplikacije smanjene, uz poboljšanje kvalitete života bolesnica. Ideju ograničene resekcije tkiva dojke predstavlja Veronesi 70-ih godina 20. stoljeća, nakon čega je i dalje nastavljeno smanjenje opsega i radikalnosti kiruških zahvata. Konačno, poštedna operacija dojke postaje standard u liječenju žena s ranim sta-dijem karcinoma dojke. Koncept biopsije limfnog čvora čuvara kod karcinoma dojke nailazi na svekoliku prihvaćenost, a njegovim usvajanjem mnoge su bolesnice pošteđene radikalnih disekcija aksilarnih limfnih čvorova, od onih čiji je nalaz biopsije limfnog čvora čuvara bio negativan do onih s mikrometastazom u istome (malim tumorskim depozitom veličine 0,2-2 mm), dok zaključci novijih studija iz posljednjih deset godina sugeriraju da se i u žena kojima je biopsijom utvrđena metastaza u jednome do dva limfna čvora čuvara disekcija aksilarnih limfnih čvorova može izbjeći bez štetnih posljedica, uz primjenu adjuvantne radioterapije.
Keywords (english)
Keywords (croatian)
Languageenglish
Languagecroatian
Publication typeProfessional paper - Review paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleActa medico-historica Adriatica : AMHA
Numberingvol. 19, no. 1, pp. 125-136
p-ISSN1334-4366
e-ISSN1334-6253
URN:NBNurn:nbn:hr:184:271943
Publication2021
Document URLhttps://hrcak.srce.hr/263467
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2021-11-03 15:05:29