A 33-year-old woman comes to the office with a 6-cm rapidly growing tumor of the left breast. The tumor has a bluish hue and skin veins are dilated. A phyllodes tumor is diagnosed, and surgical excision is planned. Which of the following is the most appropriate surgical procedure to treat this patient?  

A 36-year-old woman with genetic susceptibility to breast cancer is scheduled to undergo bilateral prophylactic mastectomy. She has elected to proceed with immediate single-stage reconstruction using permanent silicone implants and acellular dermal matrix. Which of the following is the most sensitive method to detect implant rupture in this patient? 

A 42-year-old woman with a history of a cesarean delivery from a low-transverse abdominal incision is scheduled to undergo a unilateral deep inferior epigastric perforator (DIEP) flap breast reconstruction. BMI is 28 kg/m² and the distance from nipple to sternal notch is 24 cm per side. This patient's history of cesarean delivery is most likely to have which of the following effects?  

A 54-year-old man is scheduled for correction of a defect on the back 1 week after undergoing resection of a 3x3cm recurrent sarcoma. The skin was closed primarily during the procedure, but skin necrosis and wound breakdown occurred. History includes radiation therapy to the spine for soft-tissue sarcoma 2 years ago. Physical examination shows a 5x5cm defect in the mid back at the level of T10 with exposed spinous processes. Which of the following is most appropriate to achieve complete wound closure?  

A 53-year-old woman comes to the office because of ulcerated tissue 6 weeks after undergoing radiation therapy for breast cancer. She underwent mastectomy 1 year ago. Analysis of the radiated tissue is most likely to show an increase in which of the following?