Finding out that you or a family member has breast cancer is undoubtedly a huge shock. But the best way to face the difficulties is to have the courage to solve them, which requires you to think and cope calmly. You should listen carefully to your doctor’s advice and cooperate with him/her in diagnosis and treatment. The first thing is to get the diagnosis as much as possible. Breast cancer related tests including blood test, ultrasound, mammogram, MRI, etc. are not considered to be confirmed in the real sense. Clinically, a definitive diagnosis refers to cellular or histological pathology, which usually requires a lump puncture or lump excision for biopsy. Pathological diagnosis helps to develop a more reasonable and appropriate treatment plan. However, not all tumor cases can be diagnosed preoperatively, and a larger percentage of tumors require surgical biopsy to confirm the diagnosis. Therefore, I say that preoperative diagnosis should not be forced when possible, and excessive preoperative testing can sometimes delay diagnosis and treatment. Secondly, it is to determine whether surgery is possible or not. Based on the initial examination, the doctor will get a general impression of whether the disease is early or late and whether it can be operated. Even operable breast cancer sometimes requires preoperative adjuvant treatment, while some cases should be operated directly. Do not forgo pre-operative treatment that should have been done for fear of delaying surgery, and do not delay surgery because of superstitious beliefs about the effects of medications. Trust your doctor’s judgment and protocols; after all, even if you are highly educated, your understanding of medicine is unlikely to surpass that of a specialist just because you googled or read a few articles of literature. Medicine is a combination of science and the art of experience, and it usually takes a decade or so of immersion to reach a high level of sophistication. Thirdly, let’s focus on the surgical approach. The true meaning of radical breast cancer surgery began in the 1890s, followed by a modified phase and an expanded phase, accompanied by controversies and advances in between. Currently, the common surgical procedures for breast cancer are divided into three categories: modified radical surgery, radical breast cancer surgery with breast preservation, and radical breast cancer surgery with simultaneous breast reconstruction. Modified radical breast cancer surgery is the more classical one, and the latter two have the advantages of cosmetic results and psychosocial aspects. Breast-conserving surgery is usually performed when the following requirements are met: 1. the disease is at an early stage; 2. the mass is small (standards vary from country to country, usually requiring a mass of less than 3 cm); 3. there is only one mass or more than one mass but it is confined to a small area (the latter requires great care); 4. the mass does not invade the skin or chest wall; 5. there is no connective tissue disease (which can affect the postoperative period) 6. Patients who are too young or have a family history of other high-risk factors should choose breast-conserving surgery carefully; 7. The mass is far from the nipple areola (relatively speaking, in practice it depends on whether the tumor can be completely removed while preserving the nipple areola, and some people do breast-conserving surgery to remove tumors in the central region). There are two special cases for breast-conserving surgery: one is when the stage of the disease is very early and only a lump removal and axillary lymph node biopsy is needed; the other is when the lump is large but the overall assessment of the stage of the disease is not too late and neoadjuvant therapy (including chemotherapy, radiotherapy and endocrine therapy) can be done first, followed by breast-conserving surgery. If the assessment of the disease is not suitable for breast-conserving surgery, but a better cosmetic result is desired, then modified radical breast cancer surgery with breast reconstruction is a good choice. Commonly used breast reconstructive procedures include implant placement and tissue graft reconstruction. However, there are risks such as infection, deformation and rupture of the implant, and rejection of the implant. Tissue grafting is mainly done with autologous tissues, including vascularized tissue grafting, free tissue grafting, and fat grafting. The first two are more traumatic, and the survival of the transplanted tissue is the focus, while fat transplantation is prone to saponification and atrophy leading to deformation of the reconstructed breast, and is also not conducive to postoperative radiation therapy. My own experience is that allogeneic tissues are better than autologous tissues, distant tissues are better than adjacent tissues, and breast preservation is possible if possible. Many patients may worry whether breast conservation or breast reconstruction will affect the outcome of treatment. I have focused on breast cancer surgery for ten years, and among the thousands of breast cancer surgeries I have performed independently, breast-conserving surgery has been performed in nearly 30% of cases, and breast reconstruction in dozens of cases, all of which have achieved good therapeutic and cosmetic results. There are more than 90% of cases with follow-up, no local recurrence and only about 6% of cases with distant metastasis.