New approaches in breast cancer surgery

Today compliance with oncological safety in the surgical treatment of breast cancer is inherent in achievement of the optimal cosmetic result. Over the past century surgical treatment of breast cancer has evolved from an extensive, crippling mastectomy in Holstead’s way to a tumorectomy and a biopsy of the sentinel lymph nodes. At the same time the integration of plastic and vascular surgery into oncology of breast made it possible to expand the range of reconstructive and plastic surgeries. Nowadays a breast conserving surgery with adjuvant radiotherapy remains the «gold» standard in treatment of patients with early breast cancer. The widespread usage of breast plastic surgery technics allowed to increase the number of breast conserving surgeries and to introduce the concept of «oncoplastic surgeries». A radical mastectomy remains a high-demand surgery which is likely determined by the traditional and historical views of patients. In some cases oncologists also consider this type of surgery as a more radical method of treatment. Nevertheless, according to the new trends planning and carrying out of mastectomy should be combined with a reconstructive breast surgery. A subcutaneous, skin-preserving mastectomy with an immediate reconstructive breast surgery allows to significantly improve the quality of the treatment, i.e. its aesthetic component. The usage of endoscopic methods discovers the alternative versions of minimally invasive operations. New trends in the breast cancer surgery minimization are common not only for the breast tissue but also for the axillary lymph nodes. A biopsy of the sentinel lymph nodes has become a standard procedure in the early stages of breast cancer. Today it expands the range of indications and spreads on patients with a positive sentinel lymph node.