SURGICAL TREATMENT FOR BREAST CANCER AND AXILLARY METASTASES: HISTORICAL PERSPECTIVE

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Breast cancer (BC) is the most prevalent female malignancy, with treatment evolving significantly since Ancient Egypt.
• Historical surgical approaches like radical mastectomy have been replaced by less invasive methods, improving patient quality of life.
• The development of breast conservation and sentinel lymph node biopsy (SLNB) marks major advancements in BC management.

Purpose of the Study:

• To review the historical evolution of breast cancer surgical management.
• To highlight the shift from radical mastectomy to breast-conserving surgeries.
• To discuss the impact of sentinel lymph node biopsy (SLNB) and its implications for axillary lymph node dissection (ALND).

Main Methods:

• Historical review of surgical techniques for breast cancer treatment.
• Analysis of the progression from radical mastectomy to modified mastectomies and breast conservation.
• Examination of the development and adoption of sentinel lymph node biopsy (SLNB) in axillary staging.

Main Results:

• Surgical management of breast cancer has progressed from extensive resections to minimally invasive techniques.
• Sentinel lymph node biopsy (SLNB) has become the standard for axillary staging in node-negative BC, reducing the need for axillary lymph node dissection (ALND).
• Emerging evidence suggests ALND can be omitted in select patients with 1-2 positive SLNs when combined with adjuvant radiotherapy.

Conclusions:

• Breast cancer treatment has seen a paradigm shift towards less invasive surgical options.
• SLNB has significantly improved outcomes and reduced morbidity for breast cancer patients.
• Further de-escalation of axillary treatment in breast cancer is possible with modern adjuvant therapies.