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Techniques that combine the skills of resection with reconstruction have led to a third approach called oncoplastic breast-conserving reconstruction. Emerging data on the oncological and cosmetic outcomes of this technique confi rm the clinical utility of this new approach to the surgical management of patients with breast cancer, as discussed in this Review.
Poorly differentiated thyroid cancers (PDTCs) are usually aggressive tumors with high rates of recurrence and distant metastases that are often resistant to radioactive iodine therapy. Tuttle and colleagues present the case of a 55-year-old man who was diagnosed with metastatic PDTC and was managed with radioactive iodine therapy. The authors discuss the current management options for patients with PDTCs that are nonresponsive to RAI therapy and highlight the need for the discovery of new systemic treatments for these patients.
While many studies assessing the cost of cancer care have been conducted in the US, to date, these studies and the underlying methods used to estimate costs have not been reviewed systematically. The authors of this article conducted a descriptive review of the published literature on the cost of cancer care in the US, and discuss the implications of the heterogeneity of their findings.
The current choice for men with localized prostate cancer lies between active surveillance and radical therapy, but overtreatment associated with therapy poses a significant challenge. The authors of this Review propose a new concept whereby only the tumor focus and a margin of normal tissue are treated. The advantages and limitations of active surveillance and of radical therapy are reviewed, with focal therapy presented as a means for bridging these two approaches. With emerging techniques that can treat to millimeter accuracy, focal therapy of prostate cancer is now possible.
Women who carry a germline mismatch-repair mutation causal to Lynch syndrome have increased risks of developing endometrial carcinoma and ovarian cancer, as well as colorectal carcinoma. This Viewpoint outlines the rationale for the use of lifesaving prophylactic gynecologic surgery in these women following childbearing, with testing and surveillance unless and until such surgery is performed.
Hypothyroidism seems to be a risk of sunitinib therapy for cancer. The authors of this Viewpoint review the evidence for the occurrence of hypothyroidism in this setting and discuss possible actions of thyroid hormone replacement in the cancer patient.