The modern concept of breast conserving surgery

The achievement on the biological behaviour and natural history of breast cancer demonstrates the same effectiveness and oncological safety of breast conserving surgery (BCS) followed by radiotherapy than mastectomy. The goal of BCS for patients with early-stage breast cancer is the complete removal of the tumor keeping sufficient surgical margins and maintaining at the same time the natural shape and appearance of the breast. In particular oncoplastic surgery (OPS) is a hybrid approach that combines oncologic principles and plastic surgical technique in order to ensure oncologically safe resection and satisfying cosmetic results. Oncoplastic breast surgeons need to become familiar with main techniques: volume displacement techniques and volume replacement techniques. Based on our experience and reviewing existent literature we described different oncoplastic techniques with specific indications and contraindications in order to standardized them. We also focused our attention on outcomes of OPS. Nowadays, it's not acceptable in the surgical management of breast cancer not taking care of oncological and cosmetic needs of individual patients. Oncoplastic preserving surgery is oncologically safe and allows to excise the tumor with negative margins without compromising aesthetic outcome. Oncoplastic breast surgery can be applied in larger tumors, resulting in comparable postoperative complications, resection margins and re-excision rates compared to standard lumpectomy. The excitement related to this procedure comes from reported data that seem to demonstrate a higher oncological safety and better cosmetic efficacy.