Surgery for breast cancer -- from radical mastectomy to breast-conserving surgery

Treatment for breast cancer requires a multidisciplinary approach. The role of surgical treatment for breast cancer has changed over the past several decades, while the paradigm shift in the understanding of the natural history of breast cancer has gone from local disease theory to systemic disease theory. Under these circumstances, surgical procedure has become less aggressive and less invasive. Also, the introduction of primary systemic therapy for breast cancer could modify local treatment. On the other hand, the significance of local control on long-term survival has emerged from meta-analysis. We should understand surgical treatment as part of the multidisciplinary treatment. In this review, we introduce a change in surgical strategy for patients with breast cancer, and discuss the role of surgical treatment with in the recent multidisciplinary treatment.