**Conflict of interest**

With the rapid global uptake of OPS, there remains a real danger of potentially worse patient outcome due to poor technique, improper patient selection or decision making. This is one specialty where good surgical skills are essential and inadequate training reflects on the operative outcomes with results which are glaringly obvious to both patients and clinicians. There are well-established OPS training programmes in the UK, and post-fellowship trainees in Australasia are encouraged to undertake at least 2–3 years of additional clinical training in accredited centres. The additional training serves to up-skill their technical prowess and more importantly, learn the complex process of patient selection and the art of good communication. The rationale for oncoplastic breast surgery as an integral part of all breast cancer

In summary, oncoplastic breast surgery has established a firm place in the global fight against breast cancer. Patients should be offered the appropriate range of surgical treatment options instead of the conventional two-operation strategy, prevalent for the past 40 years. Clinical discussions are therefore more complex and additional time and expertise is required to help patients with decision-making. Having a well-trained and experienced breast care nurse is invaluable in a busy oncoplastic breast practice. A multidisciplinary team approach is an integral part of modern cancer management with early contribution of clinical psychologists in selected cases. Developing an oncoplastic breast surgery practice from the ground up, can be time-consuming and challenging. It is possible to establish a modern oncoplastic breast surgical practice despite the usual constraints of a public health system and help women achieve a satisfactory cosmetic outcome combined with safe oncological treatment of their breast cancer. Surgical residents should be trained to a high standard and accreditation of oncoplastic breast surgical training is crucial to avoid repeating the historical mistakes of the laparoscopic era. The Royal Australasian College of Surgeons has recently set up an oncoplastic breast surgery master's programme for post-fellowship trainees. This will become mandatory to help standardise clinical knowledge, technical expertise and competency levels with peer review and audit. Monash University, in Melbourne, Australia, has been tasked with monitoring all breast implants used in reconstructive surgery to ensure a national registry service for breast

Whilst a detailed description of oncoplastic breast surgery has not been possible, this chapter hopes to offer a broad overview of modern surgical practice with emphasis on implant-based

The author wishes to acknowledge the continued dedicated efforts of Maria Winter, Oncoplastic Breast Care Nurse, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.

surgery has been eloquently detailed in a review article [40].

**11. Conclusion**

40 Breast Cancer and Surgery

surgical prosthetic devices.

**Acknowledgements**

reconstruction.

There are no conflicts of interests to declare.
