الفهرس 
• IntroductionOnly 14 pages are availabe for public view
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Abstract
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 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.