Current Surgical Innovations in the Treatment of Breast Cancer

Surgery is an essential component in the management of treatable breast cancer. With the use of standardized staging and data collection, evidence-based management of breast cancer has evolved to limit treatments to what is necessary but sufficient to allow tissue preservation and control of treatment-specific morbidity. As more tumors are discovered by pretreatment imaging and are not identifiable on physical exam, intraoperative tumor localization techniques have become increasingly sophisticated and reliable. Techniques for localization of “sentinel” nodes has become increasingly accurate and technically less complicated. Surgical treatment may occur after pretreatment with systemic agents (neoadjuvant) or a part of reconstruction (oncoplastic resection). Post-surgical morbidity has become an increasing focus of concern as more patients survive breast cancer with modern therapy. Cosmetic deformity is a significant cause of distress in many patients and attributed to causing delay in seeking treatment and contributing to postoperative depression. Reconstruction with autologous tissue or prosthetic implants is offered with increasingly improved results and patient satisfaction. This chapter provides an overview of the current surgical innovations in the treatment of breast cancer. Specialized techniques employed in the surgical management of breast cancer in our practice are also discussed.