Breast Conservation Surgery State of the Art英文文献资料.docVIP

SAGE-HindawiAccesstoResearch InternationalJournalofBreastCancer Volume2011,ArticleID107981,10pages doi:10.4061/2011/107981 ReviewArticle BreastConservationSurgery:StateoftheArt JonathanWhite,RajAchuthan,PhilipTurton,andMarkLansdown TheBreastCareUnit,LeedsGeneralIn?rmary,Leeds,WestYorkshireLS13EX,UK CorrespondenceshouldbeaddressedtoJonathanWhite,jonathanwhite@.uk Received28February2011;Accepted29May2011 AcademicEditor:MahmoudB.El-Tamer Copyright?2011JonathanWhiteetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Breast conservation surgery is available to the vast majority of women with breast cancer. The combination of neoadjuvant therapies and oncoplastic surgical techniques allows even large tumours to be managed with a breast-conserving approach. Therelationshipbetweenbreastsizeandthevolumeoftissuetobeexciseddeterminestheneedforvolumedisplacementor replacement.Suchanapproachcanalsobeusedinthemanagementofcarefullyselectedcasesofmultifocalormulticentricbreast cancer.Theroleofnoveltechniques,suchasendoscopicbreastsurgeryandradiofrequencyablation,isyettobepreciselyde?ned. 1.Introduction [7]. The role of salvage breast conservation surgery in the managementoflocalrecurrence,orametachronousprimary cancer, is controversial, and should be considered with caution. The replacement of obligatory mastectomy, be it radical or modi?ed radical, by simple mastectomy or wide local excision and adjuvant radiotherapy, re?ected a paradigm shift in the understanding of breast cancer pathology and biology [1]. The combination of multimodal treatments, both locoregional, in the form of conservation surgery and radiotherapy, and systemic endocrine treatment and chemotherapy,hasresultedinreducedpostsurgicalmorbid- ity without compromising oncological outcomes [2]. The conceptofdownstagingtumoursbymeansofneo-adjuvant chemotherapy or