Breast cancer is the most common malignant tumor in women, and its incidence is still increasing year by year, with more than 4,000 new cases of breast cancer detected each year in Shanghai alone. Therefore, it is important to understand the advantages and disadvantages of different surgical options for breast cancer in order for patients to choose the surgical option and cooperate with the doctors actively. The first surgical descriptions of breast cancer were in the Middle Ages, when the technique of branding (i.e., removing the breast with a soldering iron) was used. After that, until 1890, the surgical treatment of breast cancer was further understood and advanced, especially the anatomical relationship between the breast and breast cancer and the axillary lymph nodes. In a report by the American physician Halsted between 1890 and 1891, he described the technique of combined pectoralis major, axillary lymph node and mammary gland excision. In the mid-twentieth century, radical breast cancer treatment was widely performed, and for a period of time, extended radical surgery was performed, including removal of lymph nodes from the neck, supraclavicular and anterior mediastinum and in some cases, partial removal of the chest wall, as well as simultaneous removal of the uterine ovaries in recognition of the estrogen association with breast cancer. Over time, enlargement has not led to improved postoperative survival outcomes for breast cancer, and with the continued development and improvement of other treatments for breast cancer (chemotherapy, radiotherapy, endocrine therapy, targeted therapy, etc.), thus narrowing the scope of surgery, currently, although surgery is still the mainstay of breast cancer treatment, different surgical approaches are often chosen depending on the stage of breast cancer and the specific case. Radical mastectomy (also known as Halsted mastectomy): This procedure involves removal of the entire breast, thorax, pectoralis major and minor muscle, and axillary lymph nodes. In recent decades, it has been recognized that this procedure does not improve the survival rate of patients, but also has a greater loss and affects the appearance and movement of the upper extremities, so it is now mostly performed when the cancer has invaded the pectoralis major muscle or when the axillary lymph nodes have metastases and are not easily cleared. Extended radical mastectomy: In addition to the above procedures, the lymph nodes adjacent to the internal mammary artery are removed. In the past, this procedure was mostly used in cases of medial or central breast cancer with axillary lymph node metastasis, but it is rarely used nowadays due to the development of radiotherapy and the complications of surgery and the low rate of positive metastatic lymph node detection. Modified radical mastectomy: The main difference with standard radical mastectomy is that the pectoralis major muscle is preserved (Patey surgery) or both pectoralis major and pectoralis minor muscles are preserved (Anchincloss surgery), which is a relatively less damaging surgery and has better appearance and upper arm movement than standard radical mastectomy, so it is now widely used in clinical practice. Breast-conserving surgery: It is also called enlarged lump excision with axillary lymph node dissection. This surgical approach preserves the appearance of the breast to the maximum extent. It is less invasive, with fewer postoperative complications and faster recovery. As long as postoperative radiotherapy is administered, the treatment effect is the same as that of radical surgery, and the recurrence rate does not increase because of the small amount of tissue removed (confirmed by clinical follow-up data). Therefore, as long as the lump is not large (usually less than cm) and far from the nipple, and there is no diffuse calcification on mammography, and there is no residual cancer in the margins of the enlarged resection, and there is no obvious metastasis in the axillary lymph nodes, this surgical procedure can be used. Mastectomy alone: It is only suitable for old and frail patients with important organ dysfunction and lymph node metastasis, sometimes it is also used for advanced localized lesions as part of comprehensive treatment. It should be noted that no matter what surgical method is used, it is not perfect. Nowadays, it is believed that a breast cancer patient is a systemic disease when she is first seen, so surgery alone cannot solve the problem completely.