The possibility of treating cancer, a disease frequently defined by
genetic defects, by introducing genes that target these very
alterations has generated tremendous enthusiasm. This enthusiasm,
however, has been tempered by an increasing number of obstacles to
successful therapy, including vector systems that do not reach systemic
metastases, therapeutic genes with redundant mechanisms allowing for
cellular resistance, and toxicities in clinical trials that result in
premature closure. The three comprehensive sections of this volume
present currently available cancer gene therapy techniques, with
specific attention to these trouble spots. Part I describes the various
aspects of gene delivery including vehicles, or vectors, and their
respective characteristics and production methods. In Part II, the
contributors discuss strategies and targets for the treatment of
cancer, including methods for cell-death therapies, correction of
underlying genetic defects at the molecular level, and activation of
the immune system or tumor microenvironment. The contributors provide a
succinct framework for understanding the basic underlying oncogenic
changes, which encourages the development of vectors engineered to
exploit these gene mutations through selective spread of the vector in
tumor cells with the specific changes. Finally, in Part III, experts in
clinical gene therapy trials discuss the difficulties inherent in
bringing gene therapy treatment for cancer to the clinic, and principal
investigators present gene therapy approaches in the clinical testing
stage and the results that have reached the stage ofclinical
testing.of these trials.

This issue of Surgical Oncology Clinics of North America, guest edited by Dr. Kelly Hunt, is devoted to Breast Cancer. Dr. Hunt has assembled expert authors to review the following topics: Tomosynthesis in breast cancer imaging: how does it fit into preoperative evaluation and surveillance?; Lobular breast cancer: different disease, different algorithms?; Hypofractionated radiation therapy in breast conserving therapy; Oncoplastic breast reconstruction: should all patients be considered?; Neoadjuvant endocrine therapy: who benefits most?; Breast cancer disparities: how can we leverage genomics to improve outcomes?; Anatomy and breast cancer staging: is it still relevant?; When does atypical ductal hyperplasia require surgical intervention?; Surgical intervention for lymphedema; Are there alternative strategies in the local management of DCIS?; Genetic testing and genetic counseling: what is standard of care?; Molecular subtypes and local-regional control of breast cancer; Intraoperative margin assessment in breast cancer management; Triple negative breast cancer: who should receive neoadjuvant chemotherapy?; and more!

Now in this, its second edition, this fully revised clinical guidebook is an essential resource for the practitioner, allowing quick, authoritative access to the latest and best in multimodality therapies. Topics covered in this volume include everything from screening for early detection of breast cancer, through diagnostic radiology and ultrasonography, to post-treatment rehabilitation, symptom management and quality of life. Two new chapters on molecular prognostic and predictive markers, and sexuality and fertility issues in women with breast cancer, have been added. This is the 7th volume in the M.D. Anderson Cancer Care Series, featuring the best standard treatment protocols from the experts at M.D. Anderson Cancer Center.