الفهرس 
Surgical Anatomy of the Female BreastOnly 14 pages are availabe for public view
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Abstract
Breast Cancer in females still represents a serious health problem. Worldwide, breast carcinoma is the most common cancer among women. Also, breast carcinoma is the fifth cause of cancer death (after lung cancer, stomach cancer, liver cancer, and colon cancer).
Surgical treatment of female breast carcinoma has two options; “Mastectomy or Breast-Conserving Surgery (BCS)”. Nevertheless, there are some cases in which BCS is contra-indicated; as the presence of “Multicentric or Multifocal Carcinoma”.
The aim of this study is to evaluate the significance of post-Mastectomy, whole-breast histopathological analysis, for detection of; “hidden multicentricity and multifocality”, in female breast carcinoma, and its clinical implications; on the currently-used techniques and methodology, for pre-operative cancer detection, evaluation and management, and hence, this would lead to:
I. Improving diagnostic accuracy of the hidden multicentric or multifocal female breast carcinoma.
II. Reflection on our current management policy regarding the available surgical options especially for BCS.
Recent studies have pointed out that; the incidence of hidden Multicentricity and Multifocality in breast carcinoma can reach about 10.4% and in our study it was 8%.
Multicentricity is related to (risk factors):
1. Young age <40 years and perimenopausal women.
2. Family history. It is a matter of controversy.
3. Large tumors > 5cm, but, can occur in small ones.
4. Axillary lymph node affection.
5. Carcinoma in-situ (ductal and lobular), the in-situ component inside the invasive variety and the lobular histology.
6. High tumor grade.
7. Hormonal status (+ve PR, not ER).
Multicentricity plays a role in local recurrence and failed BCS is about 10.3 %.
On the other hand, it was found that; Magnetic Resonance Imaging (MRI) and digital mammography are more sensitive than ordinary Mammography, for detection of hidden multicentricity especially in fibroglandular or dense breast and hence, decrease rate of failed BCS.
Management of breast carcinoma requires co-ordination among different specialties. An integrated multidisciplinary approach with Breast and Reconstructive Surgeon, Radiation and Medical Oncologist, Radiologist and Pathologist, this often yields the most expedient evaluation and facilitates the kind of communication and co-ordination that maximizes therapeutic options with minimal recurrence rates after breast surgery especially BCS.
It is concluded that; Multicentricity has a role in local recurrence and failure of BCS.
Also, routine available investigations as tumor markers (CA15.3) and ordinary sonomammography are not able to detect these hidden lesions.
So, we recommended that; further investigations as digital mammography and breast MRI must be done for the patients before breast surgery especially BCS as this will enhance outcome and decrease the rate of failed BCS.