Over surgery in breast cancer.

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Management

Background:

• Breast surgery is a primary treatment for breast cancer, aiming for cure and local control.
• Over-treatment due to excessive surgery can lead to significant physical and emotional morbidity.
• Advances in early diagnosis, systemic therapies, and radiotherapy enable more conservative surgical approaches.

Purpose of the Study:

• To evaluate the safety and efficacy of minimizing breast surgery.
• To identify drivers of over-treatment and over-surgery in breast cancer care.
• To emphasize the surgeon's role in optimizing oncological, functional, and aesthetic outcomes.

Main Methods:

• Review of current breast cancer treatment paradigms.
• Analysis of the impact of surgical extent on patient outcomes and morbidity.
• Discussion of multidisciplinary team (MDT) roles and treatment planning.

Main Results:

• Reductions in breast cancer mortality and local recurrence rates correlate with more conservative surgical approaches.
• Tumor biology, not surgical extent, primarily dictates cancer outcomes.
• Minimally invasive breast surgery is oncologically safe and reduces patient morbidity.

Conclusions:

• Breast cancer surgery can be safely minimized to the 'minimum required' extent, focusing on disease removal.
• Avoiding over-treatment requires vigilance against factors like MDT failures and unnecessary technologies.
• Surgeons play a critical role in tailoring breast surgery for optimal oncological, functional, and aesthetic results.