Monica Morrow, chief of Breast Service at Memorial Sloan Kettering Cancer Center, New York, explains that when planning a breast cancer surgery, effectiveness, safety, and aesthetics need to be considered. However, surgical procedures have gradually committed to cosmetics results over the past 30 years.

Oncoplastic and endoscopic surgery are new techniques with minimal skin incision, but some evidence indicates that in most cases, the oncological safety of these new procedures should be carefully evaluated.

The author worries that the gains in survival rates seen in the last ten years can be lost due to low demand for thorough oncological and cosmetic evaluations.

Morrow says, “We must ensure that surgical approaches designed to improve cosmetic outcomes do not increase local failure and the risk of subsequent death from breast cancer.”

She also indicates that oncoplastic surgery and minimally invasive breast surgery are emergent fields that require a meticulous evaluation of patient reported outcomes to guarantee that new surgeries truly improve results essential to patients.

She concludes, “The local treatment of breast cancer is based on the results of numerous high quality clinical trials and is therefore a model for evidence based care. As we attempt to advance from good to great cosmetic outcomes it is important that we remember this.”