Breast conserving surgery (BCS) is no longer limited to simple wide local excision. Simple and advanced volume displacement techniques and volume replacement techniques are now becoming more commonplace. These techniques extend the role of BCS and improve the cosmetic and functional outcome. Volume displacement is becoming the preferred technique for extending BCS. We aim to discuss the indications, surgical technique, outcomes and patient attitudes towards this surgery.In my audit 37 patients were treated with “therapeutic mammaplasty” 2000–2009 (8% of all patients having BCS). Mean tumour size was 24 mm, 50% LN +ve, mean specimen weight 346 g, margins of 14 mm and 1 contralateral cancer found. 4.4% of breast cancers have contralateral pathology. This is compared to other series. In our survey on attitudes to breast reduction surgery 76% of lay people felt breast reduction was appropriate for symptomatic women, 13% felt it appropriate for cosmetic reasons only and 91% felt it appropriate as part of their cancer treatment.In conclusion volume displacement techniques are here to stay, are safe, have functional and cosmetic advantages, oncological advantages, allow extensive histolog
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