Breast cancer treatment outcomes have improved as a result of early detection and multidisciplinary treatment approaches. Treatment options continue to expand as understanding increases regarding the relationship between disease burden, biology, and outcome. In this article we present the current principles and challenges that face the clinician who is treating breast disease. Better understanding of the biology of high-risk lesions and the significance of minimal metastatic disease permits better treatment. Advances in reconstructive surgery, continued refinement of resection techniques, and the management of less common presentations of breast cancer are presented.
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