Surgical resection was the first effective treatment for breast cancer and remains the most important treatment modality for curative intent. Refinements in operative techniques along with the use of adjuvant radiotherapy and advanced chemotherapeutic agents have facilitated increasingly focused breast cancer operations. Surgical management of breast cancer has shifted from extensive and highly morbid procedures, to the modern concept obtaining the best possible cosmetic result in tandem with the appropriate oncological resection. An ever-growing comprehension of breast cancer biology has led to substantial advances in molecular diagnosis and targeted therapies. An emerging frontier involves the breast cancer microenvironment, as a thorough understanding, while currently lacking, represents a critical opportunity for diagnosis and treatment. Collectively, these improvements will continue to push all therapeutic interventions, including operative, toward the goal of becoming more focused, targeted, and less morbid. 1. Introduction Breast cancer is the most frequently diagnosed nondermatological malignancy in women and ranks second only to lung in cancer-related deaths [1]. While the incidence has increased over the past decade, (Figures 1(a) and 1(b)) the mortality rate of breast cancer has gradually declined [2, 3] (Figure 2). This improved survival may stem from earlier detection as well as improved therapies [2, 3]. Figure 1: Incidence rates of In situ (a) and Invasive (b) female breast cancer in the United States (1975–2008). American Cancer Society. Breast Cancer Facts and Figures 2011-2012. Atlanta: American Cancer Society, Inc. Figure 2: Mortality rate of female breast cancer, by race and ethnicity (1975–2007). American Cancer Society. Breast Cancer Facts and Figures 2011-2012. Atlanta: American Cancer Society, Inc. Surgical resection was one of the first effective treatments for breast cancer and continues to play a critical role in the treatment of this disease. A multidisciplinary approach is now standard of care, involving a coordinated effort with the surgeon working in concert with the medical and radiation oncologist to achieve the best possible outcome for each individual. Improvements in both the quality and quantity of life for victims of breast cancer can be attributed to the advances made in each of these disciplines. As with all cancers, earlier stage disease is more readily manageable than after significant advancement. It is these early-stage cancers in which the most significant improvements in the operative management has
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