Preface| Volume 103, ISSUE 1, Pxv-xvi, February 2023

Changing Landscape of Breast Cancer Management

Published:October 17, 2022DOI:
      As surgeons who trained in general surgery before breast surgery became its own discipline, we as editors of this Surgical Clinics issue find the expanse of changes benefiting individuals with breast cancer to be remarkable. The surgical giants, Drs Seymour Schwartz, Folkert Belzer, and David Sabiston, could never have foreseen the advancements in specialty breast cancer care. It is hard to believe that we began our training before the routine use of core needle biopsy, sentinel lymph node biopsy, and full-panel genetic testing. Indeed, many of the debates of our training, is axillary node dissection diagnostic or therapeutic?, do you have to take the nipple areolar complex at the time of mastectomy?, can chemotherapy be given prior to surgery?, have now been clinically proven. The evolution of breast cancer surgery has followed the results of clinical trials, which have proven “less is more” in a much needed effort to improve cosmetic outcomes and quality of life for our patients.
      This review is meant to be a resource for surgeons treating breast cancer patients today, recognizing clinical trials and innovation will change this landscape even further next year. Breast surgeons are expected to master current surgical techniques while also being mindful of the impact our treatments have on the quality of life of our patients. As such, this issue of Surgical Clinics incorporates articles on survivorship medicine, a burgeoning area of practice in the management of breast cancer. We have also included standard articles on updated pathology and current radiology, a discussion about practice changing clinical trials, and systemic medical management. We are excited about the discussion on new surgical techniques and novel approaches to breast reconstruction. Finally, the article on deescalation will have all of us continuing to reevaluate and examine our role as surgeons in the future care of individuals with breast cancer.
      We hope you enjoy this review of breast cancer management as much as we have enjoyed working with our colleagues to put this together.