Surgical Management of Breast Cancer in the Future

Abstract

In the 1970s the Halsted operation was abandoned for the modified, muscle-sparing, radical mastectomy by Madden or Patey; in the 1980s breast-conserving surgery was accepted in the surgical treatment of early breast cancer and during the last years of this century sentinel node biopsy has emerged as a method to avoid axillary clearance for node-negative axillae. This will lead to a diminishing number of axillary clearance procedures. Breast cancer surgery will increasingly be performed as day-case operations, under local anaesthesia. The real surgical challenges during the next decade will be immediate breast reconstruction and oncoplastic breast-conserving procedures. Therefore breast surgery will increasingly be performed by plastic surgeons.

From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy

“…Additional local recurrence after salvage mastectomy has been reported in nearly 5% of patients [8]. So, the national institute of health recognized the equivalency of medical outcome for these two procedures in a consensus development conference statement in 1990 and recommended BCT as an appropriate method of primary therapy for most women with early stage BC [3, 8, 11]. …”

“…Role of plastic surgery in surgical treatment of BC has increased during the last two decades and this trend is likely to continue during the next decade [11, 36]. Therefore, we recommend a multicentral, longitudinal, and prospective study to standardize a cosmetic outcome assessment and to clarify the indication of each technique.…”

Influence of non‐volatile anesthetics on the migration behavior of the human breast cancer cell line MDA‐MB‐468

“…The local anesthetic drug lidocaine was included in this study, as breast cancer surgery will increasingly be performed under local anesthesia as a day‐case operation (17). Treatment with lidocaine caused an increase in the percentage of migrating MDA‐MB‐468 cells in comparison with the control in all concentrations used (Fig.…”

Sentinel node and vulvar cancer: a series of 47 patients

“…The sentinel lymph node (SLN) procedure can offer an alternative approach to total inguinofemoral lymphadenectomy. The method has already been accepted in the surgical management of breast cancer and cutaneous melanoma (3), (4). The concept of the SLN is based on the assumption that the first node to receive the lymphatic drainage from the malignant tumor should be the first site of the metastatic spread.…”