Training and skills for breast surgeons in the new millennium.

Breast surgeons are learning to adapt to an evidence-based, guideline-directed and outcome-orientated culture as key members of the multidisciplinary team. Recent data has confirmed the central role of surgery in preventing recurrence, improving survival and reducing risk, and rising scrutiny is raising the standards of breast cancer treatment. Specialization is increasing in breast surgery as a result of foreshortened training, greater patient demand and increasing trainee expectations and breast surgeons are learning new skills. The balance of the breast surgeon's skill-base reflects personal preferences and professional networks, local needs and geographical -constraints, and current developments in advanced surgical training curricula. Modern training programmes need to recognize these needs, supporting interprofessional cross-specialty training initiatives and encouraging professional development. Trainees and -trainers will need to acquire new skills in diagnostic, targeted, oncoplastic and prophylactic procedures through a variety of new training initiatives. Breast surgery is standing on the threshold of change, and breast surgeons must develop new strategies, new skills and new alliances to strengthen their role in this expanding specialty.