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Professor Kefah Mokbel: New Approaches to Surgical Management

Recent advances in screening, diagnostic and multidisciplinary treatment approaches have led to higher survival rates for patients with breast cancer for all stages of disease. Breast conserving surgey plus adjuvant RT +/- systemic therapy has become the standard of care for most women with early breast cancer. Advances in modern RT technology allowed significant increase in high precision of target definition.

For early breast cancer with a clinically negative axilla sentinel node biopsy has become the preferred approach. For women requiring or opting for mastectomy, the concept of skin sparing mastectomy and immediate breast reconstruction has emerged as an option that provides excellent cosmetic results while being oncologically safe. Recent advances in microsurgical techniques have allowed the development of perforator flaps thus improving the cosmetic outcome of breast reconstruction. Mammary ductoscopoy has facilitated the visualisation of intraductal pathology.

Another advance currently under investigation is the development of accelerated partial breast irradiation (APBI) as a new concept in the adjuvant setting for early-stage breast cancer. New methods of tissue analysis including expression patterns of mRNA and proteins are promising research strategies to further advance the field and allow a more targeted and individualized therapy. It is likely that breast cancer will become an “outpatient cancer”