Surgical management of breast cancer in the future.

In the 1970s the Halsted operation was abandoned for the modified, muscle-sparing, radical mastectomy by Madden or Patey; in the 1980s breast-conserving surgery was accepted in the surgical treatment of early breast cancer and during the last years of this century sentinel node biopsy has emerged as a method to avoid axillary clearance for node-negative axillae. This will lead to a diminishing number of axillary clearance procedures. Breast cancer surgery will increasingly be performed as day-case operations, under local anaesthesia. The real surgical challenges during the next decade will be immediate breast reconstruction and oncoplastic breast-conserving procedures. Therefore breast surgery will increasingly be performed by plastic surgeons.