Thoracoscopic internal breast lymph node dissection can eliminate the need for radiotherapy It is known that in addition to axillary lymph nodes, the internal breast lymph nodes located behind the sternum are equally important in the metastatic pathway of breast cancer patients. Although extended radical breast cancer surgery has been largely abandoned, more and more studies in recent years have confirmed that internal breast lymph node metastasis is indeed a poor prognostic indicator that cannot be ignored, so it is particularly urgent to explore the accurate evaluation and treatment of internal breast lymph nodes. In this context, Long Hao’s research team has explored and pioneered thoracoscopic endolymph node dissection. This new procedure differs from lymph node sampling biopsy in that the entire lymphatic drainage area of the internal breast is resected in a continuous block under thoracoscopy, which ensures the accuracy of the assessment and pathological staging of the internal breast lymph nodes from a diagnostic point of view. The new procedure clears the internal mammary area and is a curative procedure that eliminates the need for further radiation therapy even if cancer metastases are present in the internal mammary lymph nodes, thus avoiding cardiac injury associated with radiation therapy. A randomized survey completed prior to this study showed no increased physiological injury to patients as a result of the additional surgical procedure. An article describing the results of the preliminary 50-patient study, published in Breast, a leading international journal in the field of breast cancer, showed that 40% of the patients had a change in pathologic stage due to the discovery of internal breast lymph node metastases, with six patients having a change in pathologic stage and subsequent treatment strategy due to the discovery of simple internal breast lymph node metastases. Currently, more than 100 patients have successfully undergone this new procedure.