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NCCN Guidelines Insights: Breast Cancer, Version 3.2018

Featured Updates to the NCCN Guidelines

Matthew P. Goetz, William J. Gradishar, Benjamin O. Anderson, Jame Abraham, Rebecca Aft, Kimberly H. Allison, Sarah L. Blair, Harold J. Burstein, Chau Dang, Anthony D. Elias, William B. Farrar, Sharon H. Giordano, Lori J. Goldstein, Steven J. Isakoff, Janice Lyons, P. Kelly Marcom, Ingrid A. Mayer, Meena S. Moran, Joanne Mortimer, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Melinda L. Telli, John H. Ward, Jessica S. Young, Dorothy A. Shead, and Rashmi Kumar

medical oncology, surgical oncology, radiation oncology, pathology, reconstructive surgery, and patient advocacy. In a recent version of these guidelines, the NCCN Breast Cancer Panel included updated recommendations for the use of multigene assays to

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Benjamin E. Greer and Wui-Jin Koh

the physician to perform the procedure properly. Primary Treatment The primary tumor is assessed after surgery, and nodal surgical pathology drives treatment. Postoperative radiation is given to patients with node-positive disease. Radiation

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Daniel Y. C. Heng and Toni K. Choueiri

. The pathology of renal epithelial neoplasms . Semin Oncol 2006 ; 33 : 534 – 543 . 30 Fleming S Lewi HJ . Collecting duct carcinoma of the kidney . Histopathology 1986 ; 10 : 1131 – 1141 . 31 Oudard S Banu E Vieillefond A

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Jeffrey J. Wargo, David R. Carr, Jose A. Plaza, and Claire F. Verschraegen

perform a radical lymph node dissection to reduce the tumor burden. On final pathology, the tumor was poorly differentiated, measuring 10 cm in maximum diameter, with 8 of 28 nodes positive for metastases and extranodal extension (2.5 cm in greatest

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Maxim Ivanov, Margarita Sharova, Andrea Olsen, Alexandra Lebedeva, Ekaterina Ignatova, Gerald Mouse, and Vladislav Mileyko

joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology . Genet Med 2015 ; 17 : 405 – 424 . 10.1038/gim.2015.30 25741868 3. Nykamp K , Anderson M , Powers M

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Agda Karina Eterovic, Ossama M. Maher, Joya Chandra, Ken Chen, Jason Huse, and Wafik Zaky

posterior fossa masses was performed by members of the Division of Pathology and Laboratory Medicine. Immunohistochemical studies that are pertinent to neuroblastoma and medulloblastoma tumors were used, including CD57 and neurofilaments. DNA Sequencing

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Mahmoud Al-Hawary

studies in complex pathologies such as pancreatic adenocarcinoma is the potential lack of completeness of the pertinent imaging findings or use of inappropriate terminology that is not mutually understandable by all members of the treating team. This

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Kevin S. Scher, Juan-Sebastian Saldivar, Michael Fishbein, Alberto Marchevsky, and Karen L. Reckamp

node dissection. Pathology results showed a moderately differentiated adenocarcinoma without evidence of squamous histology in any of the specimens. Margins were focally positive at the hilar and perivascular soft tissue margin. Of the 10 sampled lymph

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Lieke Gietelink, Michel W.J.M. Wouters, Pieter J. Tanis, Marion M. Deken, Martijn G. ten Berge, Rob A.E.M. Tollenaar, J. Han van Krieken, Mirre E. de Noo, and on behalf of the Dutch Surgical Colorectal Cancer Audit Group

pathology protocol to examine a TME specimen was introduced in the 1990s, related to the start of the Dutch TME trial. 5 Because of this standardization, 97% of patients included in this trial had a reported CRM. 2 In subsequent years, until the start of

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Rishi Agarwal, Jiang Wang, Keith Wilson, William Barrett, and John C. Morris

demonstrated a paralyzed left vocal cord. The patient underwent an attempt at left thyroidectomy with tumor resection that also involved the esophagus and jugular vein, and a limited left neck dissection. Pathology was consistent with anaplastic