Lobar Surgery for Breast Cancer

  • Mona TanEmail author


Breast conservation treatment (BCT) is appropriate surgical therapy for breast malignancies where clear margins and acceptable cosmetic outcomes can be achieved. Conventionally, the goal of a ‘lumpectomy’ is the attainment of a gross concentric margin of about 10 mm, resulting in a resection pattern approximating a sphere. Such an approach neither takes into account the anatomy of the breast nor the distribution of disease. It has been shown that breast parenchyma has a lobar anatomy, and disease conforms to a pattern referred to as ‘the sick lobe’. Preoperative mapping with imaging and tumour resection respecting these anatomic and pathologic proclivities optimise excision of disease segments, as well as facilitate parenchymal closure for good cosmetic results, and can increase BCT rates when appropriately applied. These objectives form the basis of lobar surgery for breast cancer, and the technical manoeuvres which take cues from the sick lobe theory to achieve optimal treatment outcomes are discussed in this chapter.


Multifocal multicentric breast cancer Breast conservation treatment Lobar surgery Sick lobe Cosmetic outcomes 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.MammoCareSingaporeSingapore

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