الفهرس 
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Abstract
SUMMARY
It is essential that any surgeon performing surgery on the
breast understands the principles and concepts of oncoplastic
surgery and develops a minimum or core repertoire of
oncoplastic knowledge and skills. It is no longer acceptable for
a surgeon to create a diagnostic scar that might compromise
future oncoplastic procedures nor understand what can be done
to minimize an oncological defect at the time of the primary
procedure.
Oncoplastic surgery is particularly complex and
demanding; it requires not only a high level of technical
competence but also proficiency in skills such as clinical
judgment, decision making and communication. Modern
patients are well informed with high expectations, which
mandate careful and sensitive management. These “softer,” less
well-defined skills are what determines surgical expertise but
they can be more difficult to acquire as well as to teach and
assess.
Overall, oncoplastic breast surgery is well evidenced and
clearly warranted to facilitate wide excision and clear margins
without compromising esthetic outcome. While today’s
operative settings increasingly include specialist oncoplastic
surgeons involved in both simple manipulations and
sophisticated reconstruction - applying even to immediate
Summary
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intervention following skin-sparing mastectomy, traditional
collaboration between oncologic and plastic surgery in some
situations would remain a viable and valuable treatment option.
There still remain challenges and future developments in
this exciting field of oncoplastic breast surgery. There are
numerous benefits to be gained from OBS, which satisfies the
primary oncological goal of tumour excision, often with
increased margins, and yields good aesthetic outcomes. The
latter may actually be an improvement on the pre-operative
state with a harmoniously shaped, less ptotic breast mound.
Symmetrisation of large breasts ameliorates the symptoms of
macromastia and provides an ideal opportunity to evaluate the
contra-lateral breast for occult malignancy. The options for
women with breast cancer are numerous, and this approach
need to critically evaluate results, measuring functional,
oncologic, and aesthetic outcomes in an attempt to establish
safe and effective practice guidelines to maximize oncologic
safety.