Whether to do surgery or puncture for patients with breast nodule category 4A needs to be determined on a case-by-case basis. For lumps that are suspected to be malignant, a puncture biopsy should be performed; for lumps that are smaller in size, they can be treated directly with surgery. Breast nodule category 4A, which indicates that a woman has a high grade nodule, is still usually a benign nodule with a 2%-10% malignancy rate. Therefore, patients are advised to undergo further molybdenum target test so as to rule out the possibility of malignant lesions. 1. Puncture: If the size of the nodule is large and malignant tumor is suspected, it is recommended to perform a puncture first to get the preliminary pathological results, so as to facilitate the doctor’s next step of treatment; 2. Surgery: If the swelling nodule is too small, performing puncture may result in inappropriate sampling, and it is recommended to perform surgical excision first, and then proceed to the next step of pathological examination; In addition, patients with breast nodule category 4A should maintain a good and optimistic mindset and actively cooperate with doctors for treatment.