Breast cancer patients are faced with two choices: breast-conserving surgery or total mastectomy. Choosing the most suitable surgical method requires consultation among the doctor, patient and family. Breast cancer is a systemic disease and the main reason for treatment failure is recurrence and metastasis. The most common causes of recurrence are bloodstream metastasis and lymphatic metastasis. If the patient selection for breast-conserving surgery is appropriate, the local recurrence rate can be controlled to about 5%, and the survival rate of patients is similar compared with total mastectomy. Second, what are the effects of total mastectomy on patients? It is mainly reflected in the loss of good body image, loss of self-worth, loss of feminine characteristics, impaired sexual attractiveness and sexual function. Although the body balance is maintained by wearing a prosthesis, there are embarrassing situations when wearing a prosthesis, such as whether the prosthesis will be displaced when participating in strenuous sports? Is it convenient to wear a prosthetic breast when participating in swimming and hot springs? Can you ensure body symmetry when participating in important social events? What factors affect the patient’s choice of surgery? Patients who choose total mastectomy tend to be elderly, fear radiotherapy, have a low level of education, have poor economic conditions, and live in remote areas, while patients who are younger, have a better economic and cultural level, and live in urban areas are more likely to choose breast-conserving surgery. IV. Which patients are suitable for breast-conserving surgery? Patients with relatively early stage, limited lesions, lesions in the periphery of the breast, and conditions for post-operative radiotherapy are suitable; if the lesions are extensive or multicentric, lesions in the central part of the breast, and conditions for post-operative radiotherapy are not available, breast-conserving surgery should not be chosen. V. What about patients who are not eligible for breast conservation and cannot undergo total mastectomy? For patients with a strong desire for breast conservation but poor conditions for breast conservation, reluctantly choosing breast-conserving surgery will expose them to a greater risk of local recurrence. The best choice is mastectomy plus breast reconstruction if you want to maintain a good appearance and cure the disease as much as possible. VI. How to choose the timing of breast reconstruction surgery? Immediate breast reconstruction can be done at the same time as total mastectomy, or breast reconstruction can be delayed one year after total mastectomy. Compared with delayed breast reconstruction, the advantages of breast reconstruction include: (1) the excision and reconstruction can be completed in one time, which reduces the hospitalization time and cost; (2) the amount of tissue needed for breast reconstruction can be assessed in time, and the preserved breast skin and the original inframammary folds can be used for reconstruction, which is more conducive to shaping the slight sagging of the breast and better shaping effect; (3) the blood vessels can be used immediately for anastomosis with the free flap. (4) Patients do not have the psychological trauma of breast deficiency after surgery, thus reducing the incidence of psychological disorders and improving the quality of life; (5) Reconstruction of the breast plays a protective role for the patient’s chest, improves the function of the affected upper limb, reduces complications, and does not delay adjuvant postoperative radiotherapy or chemotherapy, nor does it increase local recurrence. In recent years, most surgeons prefer immediate breast reconstruction surgery. However, for some patients with advanced disease requiring radiotherapy, delayed breast reconstruction can be considered after stabilization. 7. What are the main types of breast reconstruction surgery? Breast reconstruction can be divided into three major categories according to the different reconstruction materials: ① breast reconstruction with implants, including saline and silicone filled implants; ② breast reconstruction with autologous tissues, mainly including rectus abdominis muscle flap, latissimus dorsi muscle flap, gluteus maximus muscle flap and other autologous tissues; ③ combined reconstruction with autologous tissues and implants, among which combined reconstruction with latissimus dorsi muscle flap and implants is the most common. The TRAM breast reconstruction has a large amount of tissue, good blood flow, and has the effect of abdominal wall shaping, which is especially suitable for middle-aged patients with loose abdominal skin and thick fat. It is also the most common method of breast reconstruction today.2. Breast implant reconstruction with latissimus dorsi flap is suitable for patients with a history of multiple abdominal surgeries, insufficient amount of soft tissue in the abdominal wall, future pregnancy requirements, and small or medium-sized breasts on the healthy side.3. Breast implant breast reconstruction is the least invasive and simplest method of breast reconstruction at present, with no additional incisions, reduced donor area trauma and scarring. scarring, no impact on the functional activities of the shoulder joint, and fast recovery. It is suitable for patients with early stage of disease and sufficient skin preservation. 9. Is breast reconstruction safe? The reconstruction technique does not interfere with the treatment of breast cancer, does not affect the efficacy and prognosis of the treatment, and does not affect the timely detection and retreatment of tumor recurrence.