New concept of breast cancer surgical treatment – perfect unity of radical treatment + function + aesthetics Currently, the incidence of breast cancer has become the most prevalent malignant tumor among women nationwide. The surgical treatment of breast cancer has undergone changes such as local excision, Halsted classical radical mastectomy, extended radical mastectomy, modified radical mastectomy and breast-conserving surgery. The principle of surgical treatment has changed from the “maximum treatment tolerated” to the “minimum treatment effective”, and the local treatment has become more and more humanized, and now it has developed to breast-conserving surgery and sentinel lymph node biopsy. –Breast cancer is not only a localized lesion, but also a systemic disease. In the Department of Oncology, the treatment of breast cancer has gradually formed its own treatment concept: the perfect unity of radical treatment + function + aesthetics. I. Breast-conserving surgery is recommended for patients who meet the indications for breast-conserving surgery in stages I and II, and the breast-conserving technique of plastic surgery is used for patients whose partial local excision leads to breast deformation, which ensures the aesthetic standard after local excision of the breast on the basis of thorough treatment, and most of them adopt the standard of Pauline Chang at present. For patients with stage I and II breast cancer who have negative axillary lymph nodes on preoperative imaging and ultrasound, our department has recently adopted the dye method for sentinel lymph node biopsy (SLNB), which uses a “U-shaped” cosmetic incision under the axillary fold to obtain sentinel lymph nodes. The axilla is preserved for patients with more than two sentinel lymph nodes and a negative rapid freeze biopsy. Thus, the surgical methods of “breast preservation + axillary preservation” and “single breast incision + axillary preservation” are formed, which reduce unnecessary axillary dissection and complications caused by axillary dissection, such as edema, numbness and limitation of movement of the affected limb in some patients, and completely normalize the function of the affected limb. The function of the affected limb is preserved. Third, for most patients, including those who refused breast conservation, axillary preservation and those who were not eligible for breast and axillary preservation, our department used Auchincloss procedure (modified radical surgery I). In the specific implementation of the surgery, the concept of radical treatment + function + aesthetics is still reflected: the three stations and seven preserved surgical styles have become the minimum standard, reflected as follows: 1. abandoning the previous longitudinal or oblique surgical incisions, more than 90% of patients adopt the modified stewart transverse shuttle incision, which has ① good concealment (the incision is not exposed when wearing low-necked clothes); ② small impact on shoulder joint activities; ③ not easy to cut transverse (3) not easy to cut the transverse vascular nerve, preserve the chest wall skin sensation and reduce skin margin necrosis. 2. For patients who need to perform axillary lymph node dissection, we thoroughly dissect the fatty lymphatic tissue under the plane of axillary vein-humeral arch to semilunar ligament, including the large and small intermuscular muscles, to achieve pulsation and fascialization. Because most of the patients with advanced disease are in poor financial condition, they spend most of their savings or even go into debt for the first treatment, and if recurrence and metastasis are caused by inadequate technology, most of them will lose their chance of treatment, which will have serious consequences. We are strongly opposed to relying on chemotherapy to escort the surgical techniques are not in place. 3, seven preserved or even more functional vascular nerve preservation. Axillary clearance, is no longer a “nest”, what should be taken away we must take away, what should be left, we strive to retain! We often see patients with numbness in the skin of the inner upper arm and the skin of the lateral ribs, atrophy of the large and small muscles of the chest, and edema of the lateral chest wall after surgery, all of which are caused by the destruction of the vascular nerves that should be left behind. At present, the functional tissues we preserve include: 1) subscapularis vessels; 2) long thoracic nerve; 3) dorsal thoracic nerve; 4) intercostal brachial nerve; 5) medial pectoralis nerve; 6) lateral pectoralis nerve; 7) pectoralis major and minor muscles; 8) superior subscapularis nerve; 9) inferior subscapularis nerve.