The same disease, in different individuals, at different stages, according to the current treatment guidelines, there are different treatment options for patients to choose from. This requires good professionalism and patient explanation from the doctor, as well as trust and understanding from the patient. Today’s and tomorrow’s surgeries are both for breast cancer patients in their early 40s. Today’s patient underwent a simple tumor resection at an outside hospital, without preoperative hollow needle aspiration or intraoperative frozen section examination, and the postoperative plan was a relatively simple but still effective surgical approach of modified radical surgery (excision of the whole breast on the affected side + axillary lymph node dissection). When her family came to me for consultation, I reviewed the information and suggested the next step: 1. mammography or MR examination to find out whether there are other suspicious lesions; 2. if there are no other lesions, an enlarged local excision should be performed and frozen section should be taken to check whether there is any residual cancer at each margin, if not, the breast can be preserved; if there are a few residuals in one or two directions, the breast can be further excised 1 cm outward and if there is no cancer on reexamination, the breast can still be preserved. If there is still cancer residue, breast conservation is abandoned.3. If there are no enlarged lymph nodes in the axilla on the affected side during clinical physical examination (doctor’s palpation), biopsy of the anterior lymph nodes can be performed, and if there is lymph node metastasis, the axillary lymph nodes will be cleared; if no metastasis is found, the axilla will be preserved. This is the approach recommended by the NCCN (National Comprehensive Cancer Network) guidelines, provided that the patient is willing to preserve the breast. Breast-conserving radical surgery and axillary preservation with negative sentinel lymph node biopsy are not significantly different from previous single modified radical surgery (excision of the whole affected breast + axillary lymph node dissection) in terms of local recurrence rate and tumor-free survival time and overall survival. Because it preserves the breast, there is more vehicle for later local recurrence than total mastectomy, but its recurrence rate must not be significantly different from the latter. Moreover, the real threat to life is often the free tumor cells latent in the blood circulation and lymphatic circulation, and these cannot be solved by total removal of the breast or one side of the armpit, even if the pectoral muscle is enlarged and so on, but need systemic treatment such as chemotherapy, endocrine and targeted therapy to deal with them. Radiation therapy must be performed after breast-conserving surgery. After repeated consideration, the patient and her family requested breast conservation and axillary preservation. The preoperative examination of mammogram and MR were free of other suspicious lesions. Today, we applied a domestic Minute Maid fluorescence detector and performed a biopsy of the sentinel lymph nodes with indocyanine green ICG+Melan double marker. The results were negative for tumor margins and sentinel lymph nodes, and the breast-conserving and axillary surgery will be completed when there are no abnormal findings in paraffin sections. The patient for tomorrow’s surgery was different in that in addition to the palpated medial breast tumor, ultrasound revealed 4 additional non-palpable masses, and the preoperative punctured tumor and at least one non-palpable mass were both invasive ductal carcinoma. It is not suitable for breast conservation, but the tumor is located medially and the possibility of metastasis to the axilla is lower than that of upper quadrant tumors, so biopsy of the anterior lymph nodes is a good way to avoid excessive surgical trauma “killing the innocent”. The whole treatment of breast cancer has shifted from “the largest amount of treatment the patient can afford” to “the smallest amount of effective treatment for the tumor” in the last century; according to the tissue classification, size, location, stage, and staging of the tumor, we can carefully analyze and provide a solution for the unfortunate patients. Together, we can provide the most suitable “personalized” surgery, chemotherapy, radiotherapy, endocrine, targeted, immunotherapy, etc. for the unfortunate patients, which is the direction of individualized and precise treatment advocated by WHO. The picture shows the first detected anterior lymph node in this surgery.