Why did my doctor recommend “removing” my “benign” breast nodule? Some female patients are puzzled. In fact, whether a nodule is benign or malignant is ultimately determined by pathology biopsy, not imaging such as ultrasound or mammography. Sometimes, the imaging tests indicate that the nodule is “benign”, but the biopsy after surgery reveals that it is breast cancer. What are the possible cases of “benign” nodules in ultrasound and mammogram that require surgery? 1. Women between 40 and 60 years old have a high incidence of breast cancer. Therefore, if a new nodule is found within 1 year for women over 40 years old, regardless of size, whether it is one or more, surgery is recommended to remove it and send it for pathological examination; 2. If a single (single solid nodule or lump > 1 cm) or multiple breast nodules are found, the choice between surgery or follow-up can be made according to the patient’s wishes. If the patient has heavy ideological concerns or does not have time to return to the hospital for regular review, resulting in failure to detect disease progression in a timely manner, minimally invasive surgical treatment can be considered; 3. Single nodule: surgery is recommended when the nodule is ≥2 cm and growing rapidly; 4. Multiple nodules: surgery is also recommended when imaging is not certain that all nodules are benign. It is difficult for doctors to determine the nature of all nodules by imaging alone, and it is possible that 1 out of several nodules may be cancerous, so pathological confirmation after surgery is necessary; 5. If patients plan to get pregnant, surgery is recommended before pregnancy. Because pregnancy and breastfeeding may lead to tumor growth or even malignant transformation, surgery is recommended to avoid difficulties in diagnosis and treatment of breast lumps during pregnancy.