ecurrence, whether patient is pre- or postmenopausal, level of invasion, size of tumor, lymph node involvementThe following are general guidelines for tailoring chemotherapy and hormone treatment:-cancers which are in situ and are noninvasive have a very low risk of spreading to other body parts and chemotherapy is not used. However, tamoxifen might be used.-If the cancer was primarily in situ but shows some evidence of spread, there is debate about whether chemotherapy or hormone therapy is used.-If the tumor is more invasive but restricted to the breast and less than one centimeter in size, many doctors do give adjuvant treatment but some dont.-If the tumor was invasive and one centimeter or more in size, hormone and chemotherapy are generally advised, whether or not there is lymph node involvement.-If there is lymph node involvement, chemotherapy or hormone therapy should always be used, even if the tumor was less than one centimeter. Chapter eleven: Breast ReconstructionBreast reconstruction is an elective surgery whose purpose is entirely cosmetic. There is no compelling medical reason to have it.Instead of breast reconstruction, an artificial breast form, a prosthesis, can be wornAccording to the American Society of Plastic Reconstructive Surgeons, in 1998 close to 70,000 women had breast reconstructionFederal law requires insurance plans to pay for breast reconstructionTwo types of breast reconstruction exist: one in which tissue from elsewhere is used to form a mound in the shape of the breast and another in which a foreign body, a prosthesis, is used.Nipple reconstruction is also possible to further enhance the appearance of the breastBreast implants can cause some discomfort. The appearance of the reconstructed breast is not identical to the original breastBreast reconstruction is now mostly done at the time of the mastectomy, when the surgeon has finished his work.In those cases where ...