Surgical management of breast cancer in the future

In the 1970s the Halsted operation was abandoned for the modified, muscle-s paring, radical mastectomy by Madden or Patey; in the 1980s breast-conservi ng surgery was accepted in the surgical treatment of early breast cancer an d during the last years of this century sentinel node biopsy has emerged as a method to avoid axillary clearance for node-negative axillae. This will lead to a diminishing number of axillary clearance procedures. Breast cance r surgery will increasingly be performed as day-case operations, under loca l anaesthesia. The real surgical challenges during the next decade will be immediate breast reconstruction and oncoplastic breast-conserving procedure s. Therefore breast surgery will increasingly be performed by plastic surge ons.