The prevention, detection, and management of XXXX .

@entity1 @entity440 @entity0 @entity2931 @entity5 @entity1722 @entity3 @entity441
The reduction in the incidence of @entity0 in @entity1 treated with adjuvant @entity440 provided a model for prevention using endocrine agents. @entity2931 -receptor-positive @entity5 can be prevented with @entity440 , but side effects limit its clinical utility, and the risk-benefit ratio is not sufficiently high to routinely recommend @entity440 as a preventive agent. Agents being evaluated in prevention trials include @entity441 and the aromatase inhibitors; these are expected to be at least as effective as @entity440 and to have fewer side effects. Core needle biopsy (providing histological information) and high-resolution breast ultrasound enhance preoperative assessment of @entity0 . Mammography remains the only screening test shown to reduce @entity0 deaths in randomised trials. Magnetic resonance imaging may have a role in screening @entity1 with inherited mutations of the @entity0 genes. Sentinel lymph node biopsy accurately assesses lymph node status and is associated with less morbidity than axillary dissection. Where the biopsy is negative (no histologic evidence of @entity3 ), no further axillary treatment is necessary. Breast reconstruction after mastectomy can produce good cosmetic results, especially where autologous tissue is used. Myocutaneous flaps using latissimus dorsi or transverse rectus abdominus muscles are increasingly popular. Adjuvant trastuzumab therapy in @entity1 whose @entity5 overexpress @entity1722 (growth factor receptor) can reduce recurrence rates and improve survival. Neoadjuvant endocrine therapy (as an initial treatment before surgery) is an underutilised treatment in postmenopausal @entity1 with @entity2931 -receptor-positive large operable or locally advanced @entity5 . It makes more @entity1 suitable for surgery and offers others the choice of breast conservation.
