Elisa Sebastiani’s scientific contributions

Breast reconstruction after a mastectomy is a surgery of extreme importance to women and it has many psychosocial effects besides the physical ones.

In the last century, breast-cancer surgery underwent a dramatic development, starting from the initial approaches of radical surgery to the more recent codification of a series of conservative treatments that do not invalidate oncologic radicality. In 1894, Halsted [1] delineated radical mastectomy, which remained the standard treatment for breast cancer for many years. This operation, involving the removal of all the breast tissue (en bloc removal of the breast and overlying skin, both the pectoralis major and minor muscles and the axillary lymph nodes from Berg level I to III) was a fundamental shift in the surgical treatment of this disease (local disease control), but it was also a symbol of destruction, of a large wound, not only in surgical terms, suffered by the patient. In 1948, Patey and Dyson [2] of Middlesex Hospital, London, proposed an alternative approach to reduce the morbidity of Halsted’s operation (with the preservation of the pectoralis major muscle and the removal of the pectoralis minor muscle, the axillary lymph nodes could equally be removed). This was perhaps the first shift toward a more local conservative surgery.

Breast cancer (BC) is a nosological entity of high social interest due to its high rate of occurrence, as well as to the devastating consequences that patients may suffer, both esthetically and psychologically, and also in terms of the economic and organizational commitment to research and public health that it entails.