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Breast Cancer Management for Surgeons pp 213–227Cite as

Surgery to the Breast: Breast Conservation Techniques

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Abstract

Breast-conserving surgery, combined with breast radiotherapy, is a well-established treatment for breast cancer, providing equivalent overall survival to mastectomy but improved quality of life. Breast-conserving surgery is offered to an increasing proportion of women with breast cancer due to the advent of oncoplastic surgery, the use of primary systemic therapy and increasing permissiveness of conservation in the presence of multifocal disease. The range of absolute contraindications is getting smaller and includes an inability to achieve a clear margin (whilst preserving reasonable cosmesis), the presence of inflammatory breast cancer and patient preference for a mastectomy. Other contraindications are relative and often surmountable with modern treatment techniques.

The risk of local recurrence has decreased steadily in the past decade with rates of 0.5% or less annually reported in modern series. This evolution has been the result of better patient selection, better surgical technique, better pathology and advances in radiotherapy and, in particular, in systemic therapy. Understanding of the risk factors for local recurrence continues to improve with greater insight into the impact of risk factors (margin width, tumour immunophenotype, grade and stage, patient age and gene carrier status) allowing better case management.

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  1. Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland, 00029 HUS

    Marjut Leidenius MD, PhD

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  1. The Medical School Department of Oncology, University of Sheffield, Sheffield, United Kingdom

    Lynda Wyld

  2. Athens University Medical School, Athens, Greece

    Christos Markopoulos

  3. Helsinki University Hospital, Helsinki, Finland

    Marjut Leidenius

  4. Department of Oncology & Radiotherapy, Gdańsk Medical University Department of Oncology & Radiotherapy, Gdańsk, Poland

    Elżbieta Senkus-Konefka

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Leidenius, M. (2018). Surgery to the Breast: Breast Conservation Techniques. In: Wyld, L., Markopoulos, C., Leidenius, M., Senkus-Konefka, E. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-56673-3_18

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