Laura J. Esserman, MD, MBA

With evidence from a number of studies, this presentation delves into the controversy surrounding the treatment, or overtreatment, of ductal carcinoma in situ (DCIS), and discusses whether or not these lesions should indeed be classified as breast cancer.

Drs. Smith, Duffy, and Tabár provide an excellent history of breast cancer screening, including a summary of the randomized trials, the technical approaches, and the range of recommendations for screening.

In this review of hepatic resectionfor metastatic breast cancer, theauthors argue that a small groupof women with isolated liver metastasesmay be appropriate candidates forsurgical resection. Although some datahave been reported, the few publishedstudies represent small, retrospectivesingle-institutional series with no standardizedcriteria for resection. Nevertheless,the potential prospect ofimproved patient outcome in the settingof liver metastases from breastcancer deserves further consideration.

In this excellent review of breastmagnetic resonance imaging (MRI),Gundry discusses the potential advantagesand disadvantages of magneticresonance in breast cancerscreening and management and givesrecommendations for how it shouldbe applied.

In 1992, the FDA decided that silicone gel-filled breast implants would be available only through controlled clinical studies, despite the fact that they had been used for mammoplasty in millions of women around the world

In clinical trials, screening mammography has been shown to reduce mortality from breast cancer by about 25% to 30% among women aged 50 years and older after only 5 to 6 years from the initiation of screening. Among women 40 to 49 years old, the evidence supporting the efficacy of screening mammography is less convincing.