Surgical techniques in breast cancer: an overview

Despite significant advances in the medical treatment and chemo-manipulation of breast cancer, surgery with curative intent retains a fundamental mainstay of treatment, with surgeons continuing to play a central and key role within the multidisciplinary team setting.There has been a continued evolution from the radical extirpation of 19th and 20th centuries, involving total loss of the breast, skin and underlying muscle, to the individually tailored procedures of today where the aim is for complete tumour excision whilst preserving as much of the native breast as possible. Developments in sentinel node biopsy for staging have reduced formerly extensive axillary interventions to minimally invasive levels; with the possibility of doing even less in the axilla, lying just over the horizon.Breast reconstruction is increasingly the norm and today's surgeons have an expanding range of both alloplastic and autologous techniques from which to choose. Oncoplastic surgery is the combination of simultaneous tumour extirpation using cosmetic surgery techniques. This produces improved aesthetic outcomes whilst constantly ensuring that oncologically safe surgery is performed. The recent addition of fat transfer and stem cell technology extends the possibilities even further and this article summarizes the current state-of-the art surgical techniques for breast cancer.