Towards a scientific basis for oncoplastic breast surgery - 16 Downloads
Towards a scientific basis for oncoplastic breast surgery
David Rew
The treatment of breast cancer is a rigorous discipline. Oncological surgery of the breast has been refined in a scientific manner over the past century. Over the past decade in particular, it has come under rigorous scrutiny, such that the oncological management of the various presentations of DCIS and of locally invasive and metastatic disease is now systematic and standardised from one unit to another. Breast cancer surgery has been obliged to separate from general oncological surgery into a defined subspeciality discipline in the UK and elsewhere.
Invasive disease fits one of two general patterns. There are the logical, stepwise progressive and well behaved variants, which respond with long survival times to all reasonable treatment strategies. And there are the illogical, nasty variants, which defy all of the therapeutic strategies thrown at them. We have no accurate predictors of individual tumour behaviour at the outset, and there is thus reasonable room for variation in surgical treatment strategy by way of mastectomy or conservative surgery and axillary dissection from one surgical team to another.
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