[How can breast-conserving surgery be improved even more?]

Due to population-wide screening and increased awareness of breast cancer by women, more early-stage diagnoses are being made. Breast-conserving surgery, performed according to well-established guidelines, results in the same level of local control and long-term survival as mastectomy for the same indication. The Dutch Cancer Registry has demonstrated an average local relapse rate at 5 years of about 3% in a follow-up study of breast-cancer patients. A study published in this issue show a high complete resection rate and less excised tissue volume as compared to other localisation techniques or excision by palpation only. There are two provisions: the tumour and its gross delineation must be visible by ultrasound, and the breast surgeon needs to learn the technique and apply it sensibly. Generally speaking, ultrasound-guided breast-conserving resection of invasive breast cancer may well lead to more initially complete resections and better cosmetic results.