Dictionary Adjuvant therapy (AD-joo-vant) — Any additional treatment that is given after a cancer is removed surgically. Adjuvant therapy may include chemotherapy, radiation therapy, or hormonal therapy. Areola (a-REE-o-la) — The area of dark-colored skin on the breast that surrounds the nipple. Aromatase Inhibitor — Medication given to post menopausal estrogen receptor-positive breast cancer patients to block the production of estrogen. Aspirate (AS-pi-rit) — The fluid and/or cells withdrawn from a lump (often a cyst) or a nipple, using suction, or to aspirate/withdraw fluid from a lump or cyst using suction. Atypical ductal hyperplasia (ADH) — Abnormal or nontypical cells that are found in the ducts of the breast. ADH is not the same thing as DCIS or ductal carcinoma in situ. Axilla (ak-SIL-a) — The underarm or armpit. Benign (beh-NINE) — Noncancerous, not malignant; does not invade nearby tissue or spread to other parts of the body. Benign tumors usually grow slowly and stay in the site at which they originated. Biopsy (BY-ahp-see) — A procedure used to remove cells or tissues in order to look at them under a microscope to check for signs of disease. Breast conservation — Refers to saving or conserving the breast; not removing the breast. Cancer — A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissue and can spread through the bloodstream and lymphatic system. There are more than 100 kinds of cancer. Cancer Information Service (CIS) — The information service of the National Cancer Institute (1-800-4-CANCER). Assistance is provided free and is available in English and Spanish. Real people answer the phone, no callers are solicited for donations, and no names, addresses or phone numbers are kept in a data bank. Written literature is available. A computer instant-messaging service, LiveHelp, is also available at www.cancer.gov (Search: CIS, LiveHelp). Telephone service: Monday-Friday 9 a.m.-4:30 p.m. LiveHelp: 10 a.m.-10 p.m. (PST). Carcinoma (kar-sin-O-ma) — Cancer that begins in the skin or in tissues that line or cover internal organs. Chemo-prevention — A drug (such as tamoxifen or raloxifene) that is used to prevent the development of cancer. Chemotherapy (kee-mo-THER-a-pee) — Treatment with anticancer drugs. Clear margins — No cancer cells or DCIS cells are found around the edge of the biopsy. Clinical trial — A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. Comedo (kuh-ME-do) — A subtype of DCIS indicating a high grade of disease, which translates to higher risk for development of invasive breast cancer. Comedo looks and acts differently from other in situ subtypes. The center of the duct is plugged with dead cellular debris, known as "necrosis". This is a sign of rapid and aggressive growth. Also called Comedocarcinoma when it is in an invasive form. Cribiform — Cells that do not completely fill the ducts; the pattern has little holes and slits. A subtype of DCIS; low grade of disease. Cyst (sist) — A sac or capsule filled with fluid. Cytopathologist — A pathologist who specializes in examining fine needle or pap smear tissue samples at the cellular level to diagnose disease. Duct — A tube-like structure that is part of the milk-producing glands of the breast; a common site for breast cancer and DCIS. Ductal carcinoma in situ (DUK-tal kar-sin-O-ma in SYE-too), or DCIS — Abnormal cells that involve only the lining of a duct. The cells have not spread outside the duct to other tissues in the breast. Also called "intraductal carcinoma." Epidemiology — A branch of medical science that deals with the incidence, distribution and control of a disease in a population. Estrogen (ES-tro-jin) — A female hormone. Excision — The procedure of removing by cutting; a surgical removal. Gene — The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Grade — A degree of severity of a disease or abnormal condition. Cells are graded by how much they look like normal cells. HER-2/neu (also called c-erb B-2) — A gene that codes for a protein that sits on the surface of the cell. According to some estimates, 20% to 25% of breast cancers have too much of this protein on the surface of the cancer cell. Too much of this protein causes cells to grow faster. High grade — Being near the upper, most serious extreme of a specified range; more likely to grow faster and metastacize. Cells are graded by how closely they resemble normal cells. Hormones — Chemicals produced by glands in the body and circulated in the bloodstream. Hormones control the actions of certain cells or organs. Insomnia — Difficulty with sleeping. Invasive cancer or carcinoma — Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called "infiltrating cancer." Lesion (LEE-zhun) — An area of abnormal tissue. A lesion may be benign (noncancercous) or malignant (cancerous). Low grade — Being near the lowest or least extreme of a specified range. Lumpectomy — A surgical procedure designed to remove a malignant tumor (carcinoma) or DCIS and some surrounding tissue from the breast. Generally, lumpectomy is the first step in breast-conservation therapy. Lymph (limf) — The almost colorless fluid that travels through the lymphatic system carrying white blood cells that help fight infection and disease. Lymphedema (limf-ee-DEE-ma) — Swelling of an extremity (arm, hand, leg, feet) due to poor lymph drainage caused by surgical removal of lymph nodes or damage to lymph nodes. Lymph node dissection — Surgical removal of some of the lymph nodes under the arm. Lymph nodes — Small structures located throughout the body along the channels of the lymphatic system. Lymph nodes store special cells that fight infection and other diseases. Clusters of lymph nodes are found in the underarms, groin, neck, chest, and abdomen. Also called "lymph glands." Malaise — A general feeling of illness. A feeling of malaise is a common side effect of some cancer drugs. Malignancy — Uncontrolled growth of cells that tend to invade and destroy nearby tissue and spread to other parts of the body. Malignant (ma-LIG-nant) — Cancerous. Malignant tumor — Also called an invasive tumor or cancer. Malignancy — Uncontrolled growth of cells that tend to invade and destroy nearby tissue and spread to other parts of the body. Mammogram (MAM-o-gram) — An X-ray of the breast. Mastectomy (mas-TEK-toe-mee) — A surgical procedure in which the entire breast (or as much of the breast tissue as possible) is removed. Menopause — Menstrual cycles have been discontinued for one full year or more. Metastasis (Meh-TAS-ta-sis) — The spread of cancer from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like the cells in the original (primary) tumor. Metastasize — A verb meaning the process of passive transport from the primary tumor through blood and/or lymph channels to other sites in the body. Microcalcifications — Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. Microinvasion — A very small invasive cancer that is less than 1 millimeter or 1/25th of an inch in size. Modified radical mastectomy — A surgical procedure in which the breast and nearby lymph nodes are removed, but the muscles forming a "wall" between the breast and chest are retained. Necrosis — The death of living cells or tissues caused by a lack of blood flow. Needle biopsy — The removal of tissue or fluid with a needle for examination under a microscope. Also called "fine-needle aspiration." Needle-localized biopsy — A procedure that uses very thin needles or guide wires to mark the location of an abnormal area of tissue so it can be surgically removed. An imaging device is used to place the wire in or around the abnormal area. Needle localization is used when the doctor cannot feel the mass of abnormal tissue. Noninvasive carcinoma — A carcinoma that is confined to the original site. For example, noninvasive breast cancer is confined to the ducts where it started. This is also called in situ carcinoma, noninfiltrating carcinoma, and intraductal carcinoma. Nonpalpable — Cannot be felt by you or your physician. Oncologist (on-KOL-o-jist) — A medical doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Osteoporosis — Loss of bone mass, usually in postmenopausal women. Can result in a bent spine and an increase in bone fractures. Palpable — A term used to describe a lump or thickening that can be felt by touch, usually present in lymph nodes, skin or other organs of the body. Papillary tumor (PAP-ih-lar-ee TOO-mer) — A tumor shaped like a small mushroom, with its stem attached to the epithelial layer (inner lining) of an organ. Partial mastectomy — A mastectomy in which only a tumor and an area of surrounding healthy tissue are removed. Also called a "lumpectomy." Pathologist (pa-THOL-o-jist) — A medical doctor who identifies diseases by studying cells and tissues under a microscope. Post-mastectomy syndrome — A pattern of pain in the chest wall following breast surgery. Primary tumor — The original tumor. Progesterone (pro-JEST-er-ohn) — A female steroid sex hormone that is secreted by the corpus luteum. It prepares the endometrium for implantation and later helps the placenta during pregnancy to prevent rejection of the developing embryo or fetus. It is used in synthetic forms as a birth control pill, to treat menstrual disorders and to alleviate some cases of infertility. Radiation therapy — Treatment with high-energy radiation or other sources of radiation. Recurrence — The return of cancer, either at the same site as the original (primary) tumor or in another location, after a period of time when it was thought to be gone. Re-excision — A biopsy or resection that is done again to achieve adequate margins. Resection — Removal of tissue, part of an organ or all of an organ by surgery. Risk factor — A habit, trait, or condition that increases a person's chance of developing a disease. Screening — Checking for disease when there are no symptoms. Second-look surgery — Surgery performed after primary treatment to determine whether tumor cells remain. Second primary — Refers to a new primary cancer that is caused by previous cancer treatment, or a new primary cancer in a person with a history of cancer. Secondary cancer — Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary cancer or secondary tumor. Secondary tumor — See Secondary cancer. Sensitivity — A screening test for cancer should be highly responsive (sensitive), meaning that the majority of the subjects with the cancer should test positive. Sentinel lymph node biopsy — A procedure in which a dye or radioactive substance is injected near the tumor. This material flows into the lymph nodes closest to the tumor. The surgeon looks for the dye or uses a special scanner to find the first lymph node near the tumor and removes that node to check for the presence of tumor cells. Side effects — Problems that occur when treatment affects healthy cells. Common side effects of cancer treatment are fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores and skin changes. Specificity — A screening test for cancer should be free from ambiguity, meaning that the majority of the subjects without the cancer should test negative. Stage — The extent of a cancer within the body, including whether the disease has spread from the original site to other parts of the body. Staging refers to the determination of the extent of cancer. Subclinical — Not detectable or producing effects that are not detectable by the usual clinical tests. Tamoxifen — A hormone-blocking drug used to reduce the risk of breast cancer and breast cancer recurrence. Some potential side effects may occur. Telemammography — Digital mammography that can be sent electronically to another location. Tissue (TISH-oo) — A group or layer of cells that together perform specific functions. Tomography (ta-MAH-gra-fee) — A series of detailed pictures of areas inside the body; the pictures are created by a computer linked to an X-ray machine. Also called "CT." Tumor (TOO-mer) — An abnormal mass of tissue that can be either benign (not cancerous) or malignant (cancerous). Tumor grade — The degree of abnormality of cancer cells compared with normal cells; used to predict the aggressiveness of a tumor — for example, potential for local recurrence, metastasis and rapid growth. Ultrasound — An imaging method that uses sound waves (called "ultrasound") that are bounced off tissues; the echoes are converted to a picture ("sonogram") to characterize breast masses.
Skin and Soft Tissue Infections Cellulitis Note : The most common etiology of cellulitis with purulent drainage is S. aureus , although Group A streptococci and other streptococcal species can also present in this manner. TREATMENT The following regimens include coverage for MSSA, community-acquired MRSA (CA- MRSA), and streptococci . Coverage for gram negative organisms is not need
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