Metastases determine malignancy. The main attention so far has been focused upon organ metastases. The molecular mechanisms thereof, while far from being totally elucidated, are increasingly well understood. Modern diagnostic tools now enable detection and precise localization of small lesions. In contrast, our knowl edge and diagnostic capabilities regarding metastatic spread to the'lymphatic system are rather limited. However, there have re cently been a number of interesting advances. It is the aim of this volume to submit these developments to detailed analysis. The therapeutic relevance of enhanced sensitivity in detection of lymph node metastases has to be considered in the light of in creased morbidity versus eventual prognostic improvements by modification of therapy. An interesting concept which might im prove diagnostic accuracy while reducing operative morbidity is the "sentinel node" technique. Surgical standards are lacking, however, and many fundamental questions pertaining to precise lymphatic mapping remain unanswered. Whether the sentinel node concept is of general relevance or whether it is applicable in only a few organs remains to be determined. This book offers intensive discussion of the concept from methodological and tu mor biological viewpoints. World-renowned experts with long term involvement in related basic and clinical research provide the reader with a broad survey of actual knowledge together with a critical appraisal of recent and future developments. We sincerely hope this book succeeds in providing an outlook as a reference for all clinicians on future prospects and serving and researchers in this extremely important field.

The "Europe against Cancer" programme has, from its inception, emphasised the key role which general practitioners must play in the actions necessary to achieve its aim of reduc ing the incidence and the mortality from cancer in the European Community. General practitioners, because of their day-to-day direct and continuing contact with patients, playa role not only in primary prevention and education of patients, but also in motivating their patients to accept secondary prevention and screening, some of it carried out by general practitioners themselves. These preventive activities are in addition to their traditional role in the care and management of patients with cancer at home, and increas ingly, their role in active treatment. In view of the importance of the general practitioner in the "Europe against Cancer" pro gramme, the European Commission, with a view to providing general practitioners with up-tO-date useful information, has sponsored the production of this series of publications on organ based cancers, especially written for general practitioners. MICHEL RICHONNIER Coordinator of the" Europe against Cancer" programme, Commission ofthe European Communities, Brussels Preface The present textbook is the second in the series published by the Commission of the Euro pean Communities within the context of the "Europe Against Cancer" Programme. After lung cancer, it was felt that priority should be given to breast cancer, the most frequent neoplastic disease among European women.

This volume gives a general summary of the current understanding of lymphatic metastasis and the possibilities of more specific detection of lymph node metastasis. It describes in detail the procedure of sentinel lymph node detection in urogenital tumors, neck and thyroid tumors, malignant melanoma, gastric and colorectal cancer and tumors of the breast. The potential and limitations of this new method are discussed. This book provides comprehensive insight into a both clinically and scientifically important new field which is bringing about a marked improvement in the treatment of malignant tumors.

This book provides the reader with up-to-date information on important advances in the understanding of breast cancer and innovative approaches to its management. Current and emerging perspectives on genetics, biology, and prevention are first discussed in depth, and individual sections are then devoted to pathology, imaging, oncological surgery, plastic and reconstructive surgery, medical oncology, and radiotherapy. In each case the focus is on the most recent progress and/or state of the art therapies and techniques. Further topics to receive detailed consideration include particular conditions requiring multidisciplinary approaches, the investigation of new drugs and immunological agents, lifestyle and psychological aspects, and biostatistics and informatics. The book will be an excellent reference for practitioners, interns and residents in medical oncology, oncologic surgery, radiotherapy, pathology, and human genetics, researchers, and advanced medical students.

The Atlas of Breast Surgery presents the anatomy, diagnostic procedures, and step-by-step guidelines necessary for plastic surgeons, oncologists, and general surgeons to correctly and successfully perform surgical procedures on the breast. This excellent clinical reference is a superb work of art with stunning drawings and systematic tabular presentations that enhance the text. The clear and uncomplicated design will help surgeons master procedures quickly and efficiently. Key Features: More than 200 outstanding high-quality watercolor drawings Edited by internationally renowned experts on breast surgery Modern approach, emphasizing breast-conserving strategies where oncologically feasible and in the best interests of patients Detailed, point-by-point descriptions of routine as well as more complex surgical procedures Comprehensive coverage of esthetic and reconstructive techniques as well as essential procedures for the diseased breast Plastic surgeons, oncologists, and general surgeons treating patients indicated for breast surgery will undoubtedly want to refer to this atlas repeatedly in the course of their daily practice, and it is sure to become a treasured volume in their medical library for many years. As such, it constitutes a worthy and fitting companion volume to Thieme's celebrated Atlas of Gynecologic Surgery, now in its fourth edition.