Intended for healthcare professionals


Minimally invasive surgery for breast cancer

BMJ 2009; 338 doi: (Published 20 February 2009) Cite this as: BMJ 2009;338:b557
  1. Monica Morrow, chief of breast service and Anne Burnett Windfohr chair in clinical oncology
  1. 1Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
  1. morrowm{at}

    May be trading better cosmetic outcomes for worse rates of cure

    Both oncological principles and aesthetic outcomes need to be considered when planning surgery for breast cancer. As breast conserving therapy has evolved over the past 30 years from a radical idea to an accepted standard, and as options for breast reconstruction have increased, the surgical literature has become increasingly devoted to new techniques to improve cosmetic outcomes. “Minimally invasive breast surgery” and “oncoplastic breast surgery” are the new buzzwords among breast surgeons. But what do they mean? And more importantly, how should such procedures be evaluated?

    Oncoplastic surgery has been described as “the seamless joining of the extirpative and reconstructive aspects of breast surgery performed by a single surgeon,”1 and those in the field agree that the purpose of oncoplastic surgery is to improve cosmetic outcomes.2 Minimally invasive breast surgery includes techniques of breast conserving surgery, mastectomy, sentinel node biopsy, and axillary dissection. Although initially breast conserving surgery and sentinel node biopsy were themselves considered minimally invasive, the term has more recently been used to describe endoscopic breast …

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