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Surgical specialties

Breast Surgery Diploma

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A live online diploma in breast surgery: assessment and benign disease, family history and risk, breast-conserving, oncoplastic and reconstructive surgery, the axilla, and how surgery fits with systemic therapy and radiotherapy in the multidisciplinary team (MDT).

Twenty-five weekly sessions across five modules are anchored on guidance from the UK's National Institute for Health and Care Excellence (NICE), the World Health Organization (WHO) and the European breast cancer societies, with US differences flagged where they change practice, and are taught live by practising breast surgeons you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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Mammogram X-ray of a breast, showing dense white glandular tissue within the rounded outline of the breast.
Image: craniocaudal mammogram by Dr Dwight Kaufman, National Cancer Institute via Wikimedia Commons, public domain.

Who it is for

Senior trainees, fellows and early-career consultants in breast and general surgery, and surgeons who run breast services, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Assessment, benign disease and risk

  1. 1. Triple assessment and the breast clinic

    • Assess a patient with breast symptoms using triple assessment
    • Interpret imaging and core biopsy results, including discordant findings
    • Decide which patients can be discharged and which need further tests
    • Explain how UK and US breast imaging reports differ

  2. 2. Benign breast disease and lesions of uncertain malignant potential

    • Manage common benign breast conditions without unnecessary surgery
    • Choose between vacuum-assisted excision, surgical excision and surveillance for lesions of uncertain malignant potential
    • Plan surgery for a phyllodes tumour
    • Investigate nipple discharge appropriately

  3. 3. Breast infection, inflammation and the male breast

    • Manage a breast abscess with ultrasound-guided aspiration rather than incision where possible
    • Recognise idiopathic granulomatous mastitis and plan treatment
    • Assess gynaecomastia and identify causes that need treatment
    • Diagnose and manage breast cancer in men

  4. 4. Screening, family history and genetic testing

    • Explain the benefits and harms of breast screening and how UK and US programmes differ
    • Classify a woman's familial risk using NICE criteria
    • Identify patients who meet the criteria for genetic testing
    • Interpret a genetic test result with the clinical genetics team

  5. 5. Managing high risk: surveillance, chemoprevention and risk-reducing surgery

    • Plan surveillance for a woman at high familial risk
    • Offer chemoprevention to eligible women and explain its side effects
    • Counsel a woman with a high-risk gene variant about risk-reducing mastectomy and reconstruction
    • Coordinate risk-reducing gynaecological surgery with colleagues
Module 2 · Sessions 6 to 10Early breast cancer surgery

  1. 6. Pathology, staging and the breast multidisciplinary team

    • Interpret a breast pathology report, including hormone receptor status
    • Decide which patients need staging scans
    • Explain how tumour profiling tests guide chemotherapy decisions
    • Present a case at the breast MDT with the information needed for a decision

  2. 7. Breast-conserving surgery and margins

    • Select patients for breast-conserving surgery
    • Choose a localisation technique for an impalpable lesion
    • Decide when a margin needs re-excision using UK and US standards
    • Manage a second ipsilateral breast cancer after breast conservation

  3. 8. Ductal carcinoma in situ

    • Plan surgery for ductal carcinoma in situ
    • Decide when radiotherapy and endocrine therapy add benefit after surgery
    • Explain overdiagnosis and active monitoring to a patient with low-risk disease
    • Decide when sentinel node biopsy is needed with ductal carcinoma in situ

  4. 9. Mastectomy and oncoplastic breast surgery

    • Choose between breast conservation, oncoplastic surgery and mastectomy
    • Plan a therapeutic mammaplasty or a volume replacement procedure
    • Select patients for skin-sparing or nipple-sparing mastectomy
    • Audit oncoplastic outcomes against national standards

  5. 10. Breast reconstruction

    • Discuss reconstruction options with every patient having a mastectomy
    • Choose between immediate and delayed reconstruction when radiotherapy is likely
    • Explain the complication rates of implant-based reconstruction from national data
    • Recognise breast implant-associated lymphoma and refer appropriately
Module 3 · Sessions 11 to 15The axilla and multimodal treatment

  1. 11. Axillary staging in clinically node-negative disease

    • Choose a technique for sentinel node localisation
    • Select patients in whom sentinel node biopsy can safely be omitted
    • Explain the trial evidence for omitting axillary surgery to a patient
    • Identify patients who still need axillary staging

  2. 12. The positive sentinel node and node-positive disease

    • Decide when axillary dissection can be omitted after a positive sentinel node
    • Choose between axillary dissection and axillary radiotherapy
    • Explain the lymphoedema risk of each axillary option
    • Plan treatment for clinically node-positive disease

  3. 13. Surgery after neoadjuvant systemic therapy

    • Identify patients who should have neoadjuvant systemic therapy
    • Mark the breast tumour and involved nodes before treatment
    • Plan axillary surgery after neoadjuvant therapy according to the response
    • Explain why omitting breast surgery after a complete response is still experimental

  4. 14. Adjuvant systemic therapy the surgeon must know

    • Explain the benefits and side effects of adjuvant endocrine therapy
    • Identify patients who may be eligible for targeted adjuvant therapies
    • Interpret a genomic test result in the context of age and nodal status
    • Coordinate surgery with systemic therapy in the MDT

  5. 15. Radiotherapy and the breast surgeon

    • Explain current radiotherapy schedules after breast-conserving surgery
    • Select low-risk patients for whom radiotherapy may be omitted
    • Decide when postmastectomy radiotherapy is needed
    • Plan the timing of reconstruction around radiotherapy
Module 4 · Sessions 16 to 20Special situations

  1. 16. Breast cancer in older women

    • Assess fitness and frailty before breast cancer surgery in an older woman
    • Choose between surgery and primary endocrine therapy
    • Use a decision aid to support shared decisions with older women
    • Avoid overtreatment of the axilla and breast in low-risk older women

  2. 17. Young women, pregnancy and fertility

    • Plan surgery and systemic therapy for breast cancer diagnosed in pregnancy
    • Refer for fertility preservation before chemotherapy
    • Counsel a young woman about pausing endocrine therapy to attempt pregnancy
    • Address body image and sexual health in young women

  3. 18. Locally advanced, inflammatory and recurrent breast cancer

    • Recognise inflammatory breast cancer and start the right pathway
    • Plan surgery after neoadjuvant treatment for locally advanced disease
    • Manage locoregional recurrence after mastectomy or breast conservation
    • Decide when chest wall resection and reconstruction are appropriate

  4. 19. Metastatic breast cancer and the surgeon

    • Explain the randomised evidence on surgery to the primary tumour in metastatic disease
    • Identify patients with oligometastatic disease for multidisciplinary discussion
    • Manage a fungating breast tumour with palliative intent
    • Recognise when surgery will not help and focus on supportive care

  5. 20. Survivorship, lymphoedema and follow-up

    • Plan follow-up imaging in line with current guidance
    • Recognise and refer lymphoedema early
    • Manage chronic pain after breast surgery
    • Address menopausal symptoms and psychological needs after treatment
Module 5 · Sessions 21 to 25Quality, global practice and professional standards

  1. 21. Breast implants: complications and registries

    • Assess a patient with a suspected implant rupture or capsular contracture
    • Investigate a late seroma around an implant for lymphoma
    • Discuss breast implant illness with honesty and empathy
    • Record implant procedures in the national registry

  2. 22. Quality, audit and patient safety in breast surgery

    • Use audit data to compare a breast unit's outcomes with national standards
    • Recognise warning signs of unsafe practice and act on them
    • Record consent that meets current legal and professional standards
    • Use patient-reported outcome measures to improve care

  3. 23. Breast cancer care worldwide

    • Explain the three pillars of the WHO Global Breast Cancer Initiative
    • Adapt surgical decisions when radiotherapy or systemic therapy is limited
    • Plan a pathway that reduces late presentation in your setting
    • Use key performance indicators to measure a breast service

  4. 24. De-escalation and emerging techniques

    • Appraise the evidence for minimally invasive and percutaneous breast cancer treatments
    • Explain which de-escalation approaches are standard and which remain in trials
    • Introduce a new technique through local governance and audit
    • Counsel patients who ask for unproven treatments

  5. 25. Complex case review and professional practice

    • Apply the course to complex breast cases in a panel discussion
    • Present a complication at a morbidity and mortality meeting to drive learning
    • Fulfil the professional duty of candour after harm
    • Plan your own development towards a specialist breast or oncoplastic practice

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Breast Surgery Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach