LAUSR

The field of breast surgery has undergone significant evolution since the emergence of Halstedean concept of total mastectomy (TM) [1]. In the last three decades, breast conversation therapy (BCT) which involves breast conservation surgery followed by radiation therapy (RT) has gained acceptance as a standard of care [2, 3]. In recent past, more emphasis has been laid on the esthetics of breast surgery as increasing evidence indicates that a bad cosmetic result can translate to significant depression and worse quality of life (QoL) outcomes [4, 5]. The rapidly advancing field of oncoplastic breast surgery (OBS) offers a pragmatic alternative to TM and BCT. OBS is based on the fundamental tenet that the breast is not only a functional but also an esthetic organ. Thus, OBS principles are based on integrating the principles and practices of conventional breast onco-surgery with those of plastic surgery [6]. OBS aims to achieve uncompromised oncological safety, better esthetic, and psycho-social outcomes that improve the QoL and prognosis in breast cancer patients [7, 8]. In the mid-1990s, Professor Werner Audretsch from Germany did pioneering work in OBS which then gained acceptance amongst European surgeons most notably in France, Italy, and the UK [9]. Subsequently, many breast and plastic surgeons from different parts of the world have contributed to the field via development of innovative surgical techniques and accessories, clinical management concepts, patient-reported outcome measures (PROMs) and QoL assessments [10–12]. Many breast surgeons from the UK took initiatives in developing newer concepts in OBS which changed the landscape of this emerging field. Through national implementation under the NHS, OBS gained more acceptance in the medical fraternity in particular and in the society in general [13]. Internationally, OBS is now considered as a standard of care in the personalized management of breast cancer [14]. Based on the clinico-pathology and psycho-social profile of the patient, the oncoplastic surgeon will offer the following OBS options, namely: