Update operative Therapie des Mammakarzinoms

Operative therapy of breast cancer has undergone decisive further development especially in the reduction of local radicality. Multistage therapy concepts mean that operations must not necessarily be carried out at the initiation of therapy. Radical mastectomy according to Halsted was the operative standard for breast cancer for a long time but nowadays, up to 70–80?% of patients receive breast-conserving surgery. Although this therapy has been preferred for decades, there is no final consensus on adequate resection margins. The strategy of axillary lymph node resection has also changed. Only a few years ago a complete axillary dissection was basically deemed necessary but nowadays, the available data on breast-conserving therapy do not recommend this, even in the case of positive sentinel node status. Neoadjuvant therapy concepts allow when necessary a further increase in breast-conservation. In other cases all reconstructive possibilities should be checked if mastectomy is indicated.