The incidence rate of breast cancer is gradually increasing, and there are about 1.2 million new cases of breast cancer in the world every year, especially in developed countries and in Shanghai and Beijing, which are the first place of female malignant tumors. Of course, while the incidence rate is increasing, due to the development of medical technology, the breast cancer preservation rate is gradually increasing and the mortality rate of breast cancer is significantly decreasing. As a malignant tumor, infiltrative and metastatic, breast cancer is considered a systemic and systematic disease. In the early stage of the disease, tumor cells can enter the circulatory system and cause hematogenous metastasis, which may even be earlier than lymphatic metastasis. Surgery is an important means of breast cancer treatment, but the rational application of adjuvant chemotherapy, radiotherapy, endocrine therapy, molecular targeted therapy and neoadjuvant therapy to prevent recurrence and metastasis has significantly improved the treatment effect of operable breast cancer and won more chances of cure. Comprehensive treatment is emphasized. Early detection, early diagnosis and early treatment. Early stage breast cancer (T less than 2cm, negative regional lymph nodes) not only wins the chance of breast-conserving surgery, but also greatly increases the possibility of cure (80-90% long-term survival). Since surgery and radiotherapy are local treatments that have no fundamental effect on metastasis, and metastasis is possible even in early-stage breast cancer, chemotherapy improves systemic control of the tumor, allowing better treatment of patients with malignant tumors and even those who have metastasized. In situ cancer and breast cancer less than 1cm can generally be treated without chemotherapy, but the decision should be made with reference to tumor malignancy and immunohistochemistry results. Breast cancer is metastasized through blood and lymph. For metastasis, chemotherapy is the main treatment. Etiology: 1) Family history of breast cancer (aggregation), breast cancer related genes; 2) Reproductive factors: early menarche, late menopause, few births, little breastfeeding (probability statistics); 3) Sex hormone related factors: (15-24% high total estrogen content in postmenopausal breast cancer patients, supplementation with exogenous estrogen); 4) Nutritional diet (high fat, high calorie); 5) Environmental factors. Risk factors: Any single factor mentioned above cannot simply explain the cause of breast cancer, but may be the result of the combined effect of multiple factors under certain conditions, among which there are also the effects of less breastfeeding, environmental pollution, mental and other factors. High-risk groups: 1) family history of breast cancer; 2) previous history of benign breast tumors; 3) not having children; 4) first full-term pregnancy older than 30 years; 5) early menarche or late menopause; 6) excessive consumption of animal fat and overweight after menopause; 7) long-term application of estrogen. At present, there is still no effective method of prevention, but early detection and treatment can be achieved through better use of breast screening techniques (e.g. X-ray and other methods) as well as formal physical examination and self-examination. In addition, maintaining an optimistic mood, increasing physical exercise and improving dietary structure (reducing fat and increasing vegetables and soy products) can also have a positive effect on prevention. They are divided into: non-invasive carcinoma, early invasive carcinoma, invasive specific carcinoma, and invasive non-specific carcinoma. Eczema-like breast cancer of the nipple, also known as “Paget’s disease”, is less common. It has low malignancy, slow development, and eczema-like changes in the skin around the nipple, which may lead to ulceration. It is a special type of breast cancer. Self-examination: Visual examination: bilateral symmetry, whether there is localized elevation or depression, whether there is redness, swelling and ulceration of the skin, the shape of the nipple, etc. Palpation: Palpate with the palm surface of the fingers, do not pinch the breast by hand. Palpate the outer upper, outer lower, inner lower, inner upper and central regions of the breast sequentially, as well as the axillary area. If there is a lump, especially if there is a hard mass, you should go to the hospital for further examination, in addition, those with nipple overflow should also see a doctor. Time: The examination will be clearer about a week after menstruation. You should go to the hospital immediately. In addition to the physical examination by the doctor, it can be combined with X-ray, color ultrasound examination, and in case of diagnostic difficulties, it can also be combined with nuclear magnetic or localized aspiration biopsy techniques. It is more convenient to examine after menstruation. Early stage breast cancer has no special clinical manifestations, but the discovery of a single, hard mass in the breast within a short period of time should be taken seriously, especially for women over 40 years old. Early stage breast cancer has a better prognosis, but it depends on self-examination and physical examination. Breast cancer surgery has lasted for more than 100 years from radical mastectomy, expanded radical mastectomy to modified radical mastectomy. However, with the continuous in-depth research on breast cancer in modern medicine, it is found that: comprehensive treatment is the guarantee to improve the survival rate of breast cancer patients, and the result of pursuing expanded resection does not improve the postoperative survival rate of patients. 20-year follow-up: the survival rate and local recurrence rate after breast-conserving surgery and radical surgery for early breast cancer Therefore, breast-conserving surgery has gradually replaced radical surgery in stage I and II breast cancer (maximum tolerated treatment to minimum effective treatment), and in the past 30 years, “breast-conserving” has gradually become the main surgical procedure for breast cancer. Currently, breast-conserving surgery accounts for more than 50% of breast cancer surgery in many western countries, and the breast-conserving rate of breast cancer surgery in Asian countries such as Japan and Singapore is 60% to 70%. In contrast, breast-conserving surgery in China is very limited, and even the percentage of breast-conserving surgery in some large hospitals is only 20%. In general, breast-conserving treatment is a treatment for single breast cancer less than 3 cm in diameter, including the complete regression of the tumor to within 3 cm after neoadjuvant chemotherapy (preoperative chemotherapy), which is a combination of extensive excision of the tumor, preservation of the overall shape of the breast, and postoperative radiotherapy. Among them, mainly patients with single tumor, less than 3cm, and willing to breast conserving, while for patients who have received radiotherapy on the affected side or have multiple tumors and cannot achieve negative margins during surgery should consider total mastectomy. Contraindications for breast conservation: 1) multiple primary tumors in different quadrants or diffuse and extensive invasion; 2) previous radiotherapy to the affected breast; 3) positive margins and still positive after extended excision (relative contraindication: tumors larger than 3 cm) lymph nodes). Post-operative follow-up has shown that breast-conserving patients with negative margins do not have a significantly higher rate of local recurrence than those who underwent total mastectomy in the same breast cancer patients. The goal of breast-conserving treatment is to achieve the same survival rate as total mastectomy, reduce local recurrence, and achieve good breast shape through breast-conserving surgery combined with radiation therapy. The failure of breast cancer treatment is often due to the fact that the cancer cells present in the whole body are not destroyed by drugs, not due to “incomplete” local surgery, and the complete removal of the tumor is not a blind enlargement or sacrifice of the whole organ. Therefore, we need to clearly identify the indications for breast surgery before surgery, apply color ultrasound, breast MRI and other imaging techniques to exclude multicentric breast cancer, and accurately determine the size and extent of tumor infiltration, so as to decide the safe scope of surgical excision, meet the negative surgical margins while reducing the sacrifice of normal breast tissue, thus reducing the impact of surgery on breast appearance and achieving the therapeutic requirements of breast-conserving surgery. (kearny, Morrow 0.5-1cm-95% is negative) At the same time, breast-conserving surgery must also be approached scientifically, and the option of breast-conserving surgery should be abandoned in cases of multicentric and extensive infiltrative breast cancer as well as those with persistent positive margins during surgery. Through the follow-up of breast cancer in our hospital in the past decade, the current percentage of breast-conserving surgery is more than 50%. In the same period, there is no statistical difference in postoperative survival and local recurrence rate between patients who underwent breast-conserving surgery and those who underwent total mastectomy, but there is a significant difference in quality of life and physical and mental status. It is more important to cherish the breast of breast cancer patients and the efforts of doctors. As surgeons should have the responsibility to help breast cancer patients choose the surgical method scientifically and never deprive patients of the opportunity to choose, to communicate fully and carefully with patients before surgery, and to take into account the quality of life of patients after surgery while focusing on the current diagnosis and treatment. With the development of medicine, the diagnosis and treatment of breast cancer has made great progress, and simple tumor treatment is no longer the only criterion to judge the success of breast cancer treatment, improving patients’ postoperative quality of life and restoring the missing breast has become a necessary concept for modern surgeons. For patients who must undergo total mastectomy, there are also opportunities for simultaneous or second-stage reconstructive breast surgery, and “one size does not fit all” for all breast cancer patients, as one breast cancer specialist put it: “Total mastectomy needs more justification! Radiotherapy: It can kill the local residue and prevent recurrence. Endocrine therapy: For estrogen-dependent breast cancer, estrogen has become its special nutritional factor, blocking this factor to achieve therapeutic effect and play a positive role in preventing recurrence. Triamcinolone is appropriate to be taken for 5 years (TAM: 47% reduction in local recurrence rate and 26% reduction in mortality). Breast cancer is an estrogen-related disease, and women have higher estrogen levels during pregnancy, so pregnancy should be avoided for 5 years after breast cancer surgery. 5 years later, some patients may still have children. The cause of early menopause is mostly due to chemotherapy, and taking triamcinolone acetonide can lead to endometrial thickening, but endometrial cancer caused within 5 years is uncommon, and its thickening should be checked regularly. Currently, most patients with stage I or II breast cancer can undergo breast-conserving surgery, while patients with total mastectomy can consider breast reconstruction to compensate for the effects of missing breasts and improve their quality of life. Mammary gland hyperplasia is a common benign lesion of the breast, which is neither a tumor nor an inflammatory disease, but a proliferative disease of the breast tissue, collectively referred to as “disorders of breast structure” by the World Health Organization (WHO). In China, especially in urban women, the incidence of the disease is high, more than half of them. Its pathogenesis is related to hormone regulation disorder, and the clinical symptoms are breast swelling and pain and lumps, which are cyclical and self-limiting, so the symptoms are usually aggravated before menstruation, especially in the upper part of the breast, and are affected by mental factors. However, it is worth mentioning that the differentiation of the two diseases should not be based on symptoms and signs alone, especially for the detection of early breast cancer, but also on imaging and even pathology. Thus, patients can receive timely treatment. The common clinical examination methods are mammography and color Doppler ultrasound. For example, from 1984 to the present, the number of early breast cancer cases in the United States has increased 10 times, and the detection of microcalcifications (76%), soft tissue densities (11%), and the coexistence of both (13%) provides the basis for diagnostic imaging, so mammography has been used as a routine examination in women’s annual physical examination. In addition, color ultrasound diagnostic technology has developed rapidly in recent years. For solid occupancies found in mammographic examinations, morphological features and blood flow should be carefully observed and, if necessary, reviewed within a short period of time to understand the imaging changes of the lesion, and sometimes it is necessary to use hollow-core needle biopsy under localization for suspicious occupancies and obtain pathological analysis to guide further clinical treatment. Because of the non-invasive nature of color ultrasound, it is more commonly used in review and follow-up. On the other hand, the incidence of breast cancer has increased rapidly in recent years, and now its incidence has jumped to the first place of female malignant tumors in some developed countries and some cities in China, and there has been controversy about whether breast hyperplasia can become cancerous. The so-called atypical hyperplasia refers to a high degree of epithelial cell proliferation based on a certain degree of heterogeneity in its morphology and varying degrees of disorganization or loss of cell polarity. Recent studies have also found that: sections confirmed by core-needle biopsy of atypical ductal hyperplasia show that 10%-50% of atypical ductal hyperplasia may be associated with intraductal carcinoma in situ or invasive breast cancer. From hyperplastic lesions progressing through in situ breast tumors to invasive breast cancer, deletions occur at multiple loci on the chromosome. More than 70% of intraductal carcinomas in situ are accompanied by heterozygous deletions, compared to only 35%-40% of typical hyperplastic breast growths and zero normal breast tissue. At present, there is still no exact and effective treatment for mastocytosis. Chinese herbal medicine, avoiding anxiety and other mental factors, and eating a moderate amount of iodine-containing foods and vitamins will provide some relief to breast pain, while the application of endocrine therapy such as triamcinolone will often disrupt the delicate balance between human hormones, so short-term applications are only considered when pain seriously affects work and life. In 1997, the American Cancer Society (ACS) established the principles of breast screening: monthly breast self-examination and 3-year clinical examination for women aged 18-39; annual clinical examination including mammography for women aged 40 and above. Therefore, in clinical practice, it is especially proposed that patients with breast hyperplasia should not neglect imaging examinations. Moreover, sometimes breast hyperplasia and breast cancer may co-exist, and a diagnosis of breast hyperplasia to explain it will delay the detection and treatment of breast cancer. Especially for patients with a family history of breast cancer, or production factors such as not having children, older age of first pregnancy, and long-term estrogen use, breast enlargement patients should be examined more intensively. Of course, patients with breast enlargement do not need to be overly nervous, as most of them are simple hyperplasia and usually do not develop cancer, while blind surgical removal is “over-treatment”.