2015 ASCO Advances in Breast Cancer Surgery 1. observation is an option for patients with low-grade DCIS (ductal carcinoma in situ) who are contraindicated to surgery or unwilling to operate; 2. for patients with breast-conserving surgery for DCIS, postoperative supplemental radiotherapy and endocrine therapy can provide long-term survival benefit; 3. local treatment for DCIS can be mastectomy or breast-conserving + radiotherapy (if shorter life expectancy or severe comorbidity No radiotherapy can be considered for side radiation therapy), and TAM or AI can be chosen for systemic treatment to reduce recurrence, but the benefits/risks still need to be weighed. 4. Breast-conserving margin guidelines suggest that a negative surgical margin is sufficient for breast-conserving surgery. Positive surgical margins require reoperation, and positive margins are at high risk of recurrence; negative tumor margins without lesions provide prognosis; systemic therapy may reduce local recurrence, but there is no evidence that wider margins do not require such therapy; regardless of any biological subtype, low-grade, invasive lobular carcinoma (including typical lobular carcinoma in situ at the margins), or extensive intraductal carcinoma there is no evidence that a wider resection is required margins. 5.Cautions for breast-conserving surgery: residual cavity circumcision can reduce the positive rate of incision margins, select appropriate breast-conserving patients, precise positioning methods, and avoid intraoperative freezing. 6. rising contralateral prophylactic mastectomy (CPM): benefits – reduced risk of contralateral breast cancer, reduced need for surveillance, symmetrical appearance; risks – increased surgical or postoperative complications or risks, impact on appearance, sexuality and emotion, follow-up procedures potential need. 7. Our data from 1999-2008 show the mastectomy rate: 88.8%, while the rate of breast-conserving surgery: 5.5%; the two data from the United States are 33.5% and 64.5%. Breast-conserving surgery in China still needs to be further promoted.