According to the US data, the 5-year survival rate of cancer in the US is 66.9%, while in China it is only 30.9%, which is nearly double of the 5-year survival rate in China. Do I have to have a total mastectomy for breast cancer? Generally speaking, if a tumor is found in China, the first “priority” is surgery to remove it, and if the patient wants to keep the breast, the doctor usually leaves the question, “Breast or life?” However, in the same situation, American patients have different options. In the United States, depending on the patient’s condition, doctors may consider “neoadjuvant chemotherapy” before surgery for some patients. Neoadjuvant chemotherapy allows the tumor to shrink first so that the surgeon can reduce the extent of the mastectomy. Patients usually only need a subtotal mastectomy, and with advanced breast reconstruction techniques in the United States, the embarrassment of a “mastectomy” can be almost avoided. In addition, in addition to neoadjuvant chemotherapy, U.S. doctors will arrange radiation therapy for breast-conserving patients if needed. Studies have shown that this combination therapy is similar to total mastectomy, but the quality of patient survival is dramatically improved. It has become one of the standard treatment options in the United States. In recent years, U.S. hospitals have even developed more advanced partial breast irradiation radiotherapy to shorten patient treatment time. In contrast, in China, only 27% of breast cancer patients receive radiotherapy as part of their initial treatment, much lower than in other countries. Accurate and reliable diagnosis is the prerequisite for accurate treatment, as it directly determines the treatment plan. In 2014, a study by a leading medical journal revealed some of the problems with pathological diagnosis in China. In Beijing, for example, 67.2% of new cases in 101 hospitals in Beijing lacked basic pathological information to guide treatment planning, such as histological grading and lymph node status. And in breast-conserving surgery, 25.9% of pathology laboratory reports did not reflect surgical margins. This diagnostic information is critical to the development of treatment plans! More Research, Longer SurvivalOn the flip side, more research, too, may account for the longer survival of breast cancer patients in the United States. In addition to the recent Obama-sponsored Cancer Moon Landing Project, there is also the National Cancer Institute-funded Excellence in Research Specialty Program under the National Institutes of Health, among others. Currently, several targeted breast cancer drugs are available in the U.S. In addition, 20 clinical trials in the U.S. have confirmed the effectiveness of the OncotypeDX test, which can quantify patients’ risk of recurrence, eliminate unnecessary chemotherapy, and make treatment more refined, and we have had patients who have been spared the pain of chemotherapy through this technology.