Types of breast surgeries. Benign breast lesions and non-invasive cancer

1. Big picture

This topic is about how surgeons approach breast disease before it becomes invasive cancer and how breast operations are selected.

The examiner wants you to know three things:

1. Triple assessment of any breast lesion: clinical examination + imaging + tissue diagnosis.
2. Which benign lesions can be observed and which need excision.
3. How ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), and Paget disease are managed surgically.

Breast surgery has changed from “maximal tolerated surgery” to minimal effective oncologic surgery with good cosmetic result.