With the increasing level of understanding of breast cancer, the choice of breast surgery by both doctors and patients has evolved from simply pursuing radical treatment and avoiding recurrence to requiring both surgical radical treatment and quality of life. The deeper understanding of the biological characteristics of breast cancer has led to a great change in the perspective of surgical management of breast cancer. After a large number of case comparisons, it has been found that the percentage of tumor recurrence does not increase in patients treated with breast preservation, while minimizing the harm caused by surgery. With the right choice of indications, breast-conserving surgery can have the same effect as mastectomy. What kind of breast cancer can be preserved? Breast-conserving surgery is often performed on early stage breast cancer, usually on isolated lesions with tumor size ≤ 75 px, if the tumor is large, the ratio of breast to tumor size should be considered. Generally, breast-conserving surgery is recommended when the tumor is located at the edge of nipple and areola, and the edge of the tumor is ≥50px from the edge of the areola, so that the shape of the breast will be less affected after breast-conserving surgery. Absolute contraindications to breast-conserving treatment include a history of breast or chest wall radiotherapy, pregnancy and the need for radiotherapy during pregnancy, mammography showing diffuse suspicious or malignant signs of microcalcifications, multicentric lesions that cannot be locally excised through a single incision to achieve satisfactory cosmetic results, and persistent positive surgical margins. Relative contraindications to breast-conserving treatment include: active connective tissue disease with cumulative skin and masses larger than 125 px; and positive local pathological margins. For breast-conserving surgery in patients older than 70 years of age with lymph node negative and ER positive breast cancer, if the pathology is negative for cut margins, oral tamoxifen or aromatase inhibitors can be administered postoperatively without combined radiotherapy. Breast-conserving surgery not only requires early stage of the disease, but also requires more skillful and detailed surgical techniques, necessary radiotherapy equipment and regular and systematic systemic treatment. A large number of clinical practices have proved that for early stage breast cancer, the recurrence rate and survival rate after 5 years and 10 years are basically similar between radical surgery and breast-conserving surgery plus radiotherapy, and there is no statistical difference, but breast-conserving surgery can help patients rebuild their self-confidence and improve their quality of life, which is more acceptable to female breast cancer patients. Doctors should also be more sympathetic to patients’ feelings and help them make the most appropriate choice according to their condition.