Surgery plays a major role in the primary treatment of breast cancer. There has been rapid development in breast surgery over the last 20 years. Breast conserving therapy is standard today for tumours up till 4 cm in diameter, and can be used in selected cases for larger tumours after preoperative down staging with chemotherapy. Breast conserving therapy with postoperative radiotherapy gives the same long-term overall survival as mastectomy. Axillary surgery has also developed conservatively, with the introduction of the new technique of sentinel node biopsy, which offers an alternative to axillary clearance for staging of the axilla, with less morbidity.
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