ABSTRACT
The principles of managing operable breast cancer are as follows: achieve local control of the cancer and prevent recurrence, and achieve regional control of the cancer by identification and removal of tumour-draining lymph nodes. In quadrantectomy, an ellipse of the overlying skin and the underlying pectoral fascia are removed, in addition to wide local excision of the lump. Quadrantectomy has a lower recurrence rate than wide local excision, but the cosmesis is inferior. A mastectomy results in the excision of the entire breast, including the overlying skin and the nipple/areolar complex. The patient (and their partner) should receive adequate information and counselling prior to the procedure. It is recommended that all patients with invasive breast cancer should undergo some form of axillary surgery, in order to: obtain regional disease control; establish prognostic information regarding nodal spread and allow staging; and determine the need for adjuvant therapy.
