The term “radical tumor surgery” is an old term that was developed in the mid-nineteenth century and is still in use today. The concept refers to the removal of the anatomical location of the organ in which the tumor is located and the entirety of the draining lymph nodes in patients with early-stage tumors. At that time, the view was that it was meaningful to do radical surgery only for tumors, otherwise they would recur quickly and lose their lives, so there was no meaningful surgery for patients who could not perform complete radical surgery. At that time, the definition of advanced breast cancer was a mass beyond the breast, often with skin involvement and enlarged lymph nodes in the neck – this was in the late 19th century; later it was discovered that the truly advanced tumors that could not be treated by radical surgery were those with metastases, so the original definition of “advanced breast cancer” was added to “localized breast cancer”. The original definition of “advanced breast cancer” was added to the definition of “localized”, which is now the definition of locally advanced breast cancer. With the development of imaging, metastatic breast cancer is also more often considered as inoperable breast cancer, so patients with advanced metastases are also included in the scope of infeasible radical surgery. Therefore, as an industry term, patients with early-stage operable tumors are also not referred to as being able to have surgery, but as being able to have radical surgery. Patients with advanced inoperable tumors also do not mean whether they can be operated on, but whether they can have radical surgery. Under the medical conditions of the time, inoperable breast cancer also included locally advanced breast cancer nowadays. As far as breast cancer is concerned, the anatomical location of the organ where breast cancer is located is the breast, so radical mastectomy means “removal of the entire skin and regional lymph nodes within a certain area of the breast and the surface of the mass”, the skin area was initially specified to be 5cm, later 3cm, and later less discussed. The skin area was initially defined as 5 cm, later as 3 cm, and then less frequently discussed; regional lymph nodes, initially the axillary lymph nodes, and later the internal breast and suprahepatic lymph nodes were accessed and removed. Although the concept of radical breast cancer surgery has changed a lot over 100 years, the principle of mastectomy + lymph node dissection has never changed. Because the removal of the pectoralis muscle was originally intended to facilitate lymph node clearance, whether or not the pectoralis muscle is preserved can be called radical breast cancer surgery because of the removal of the anatomical site where the cancer is located and the draining lymph nodes. Breast conservation cannot be called radical surgery because it does not follow the basic concept of radical surgery, and there is a logical conflict – how can it be both radical and partial. You can use the principle of radical treatment and see the tumor as being cut out, but the radical procedure directly prescribes cutting the breast. The concept of radical mastectomy is no longer mentioned as long as breast-conserving or SLNB (sentinel lymph node biopsy) surgery is performed. All breast-conserving procedures, from Quadrantectomy, Segmentectomy, and Lumpectomy, are called Partial mastectomy, but they can also be classified as Segmentectomy in the broader sense. The specific evolutionary process will not be described. Surgical operations: Quadrantectomy is fan-shaped, Segmentectomy is a pike shaped column, Lumpectomy is theoretically spherical, but in practice it is close to square. The really early kind of strict Quadrantectomy has long been stopped because it did not serve to preserve the appearance. Nowadays, only Segmentectomy and Lumpectomy are done, the most popular one in East Asia including China is Segmentectomy, and the most popular one in the United States is Lumpectomy. Quadrantectomy and Segmentectomy both require cutting the pectoralis fascia, and the pectoralis muscle is often visible under the microscope, because the pectoralis fascia is a natural barrier to local tumor invasion. Because the pectoralis fascia is a natural barrier for tumor local invasion, whether the basement membrane is breached or not becomes the basis for whether part of the pectoralis muscle should be removed. Lumpectomy is flexible by the surgeon according to the relationship with the posterior space. Segmentectomy, Lumpectomy is performed to ensure that the specimen remains in place during surgery – a seemingly easy thing to do. Excessive stretching always results in a large cut edge on the side cut down first and a small cut edge on the side cut down later, and the swelling always favors the side cut down later. The shape of the specimen intraoperatively and on the pathology retrieval table is slightly variable, and there is retraction of the tissue after specimen isolation, especially near the swelling, but all current treatment specifications and studies in which the cut margins are based on pathology cut margins need to be noted intraoperatively if they are transformed to intraoperative maneuvers to obtain adequate postoperative pathology microscopic cut margins. Pathology report: Segmentectom (rapid freezing) pathology needs to report not only the status of the cut edge of each circumferential break but also the distance of the microscopic cut edge, and only negative and positive skin and basal fascia are reported. Skin positivity is classified as T4, which is not suitable for breast preservation, and basal fascia involvement should be considered for partial pectoral muscle resection. Lumpectomy should be reported for six surfaces and the microscopic margin distance, also less than 2mm need to be cut again, the skin of superficial masses, and the fascia of deep masses treated with Segmentectom. How to read the pathology report of breast conservation? 1, first determine what surgery was done, whether the mass is in the middle of the specimen, whether it is cut off, the consequences of non-standard operation have been mentioned earlier, the original post is cut off; 2, whether the surgical margin is sufficient, whether the logical relationship between the surgical margin, the microscopic margin, the preoperative palpation of the mass diameter, and the diameter of the mass on the pathology sheet is consistent; 3, whether the microscopic margin is sufficient, only the breast conservation with sufficient microscopic margin is The standard breast-conserving surgery. If it is not enough, it needs to be cut again. Negative margins alone are not sufficient to consider the extent of surgery adequate. Although radiotherapy is for surgical preservation, the technical standardization of breast conservation is still necessary, and the standardization of breast-conserving radiotherapy is based on standardized surgical techniques, not on surgery that is probably its worse.