With the improvement of breast examination technology, more and more breast nodules, breast lumps, breast cysts, breast occupancy foci, etc. are found. This is a good thing. This is a good thing – it can be solved at a relatively early stage of the disease. However, this situation also poses a challenge to the traditional surgical approach. When a lesion is found and has to be treated, the thinking generally goes like this: first, do all lesions need to be removed; second, how do you cut the masses that cannot be palpated (cannot be felt by hand)? Again, how to cut multiple breast masses? Not all ultrasound-detected breast nodules need to be removed. The following lesions generally require surgery: (1) substantial masses (ultrasound indicates “hypoechoic”); (2) mixed cystic and solid lesions (ultrasound indicates “hypoechoic within an echogenic lesion”); (3) irregular blood flow in or around the lesion; (4) Other lesions with ultrasound suggestive of BI-RADS category 3 or higher. Some lesions do not require immediate surgery, such as (1) cystic lesions (ultrasound indicates “no echo”); (2) individual dilated breast ducts (ultrasound indicates “striated echogenic lesions”). (iii) Lipoma-like lesions. (iv) Hyperplasia-like nodules, which often appear as “leopard prints” on ultrasound, with each pattern resembling a hypoechoic lesion, which can be confusing to the inexperienced physician. It is important to mention here that many patients have both small cysts and small, substantial nodules on ultrasound, and they are not too large, about 5mm. In this case, do not rush to operate, but observe for a period of time, because some small cysts have clear and thin fluid, just like water, and they are “non-echoic lesions” under ultrasound; while some small cysts have cloudy and thick fluid, just like yogurt, and they may be “hypoechoic lesions” under ultrasound. “Many people gradually absorb the cystic fluid through a period of medication and follow-up, and it becomes a “non-echoic lesion”, so there is no need to consider surgery anymore. Before the advent of the minimally invasive spinotomy technique, for those masses that could not be felt, the surgeon would use ultrasound to locate the lesion before surgery and then mark it with a marker in a circle on the skin. During surgery, the marker was used to cut in and remove large pieces of tissue from the area. The problem is that these lesions cannot be felt at all, and after the injection of local anesthetic, they are even more difficult to feel. In order to make a clean cut, more tissue has to be removed so that it is not missed. Therefore, this will “affect the innocent” and will be more traumatic. For patients with multiple masses, if the lesions are concentrated, it is fine, but if the lesions are scattered, the trauma and skin scarring can be very difficult to accept. In the 1990s, the minimally invasive spinotomy technique emerged as a biopsy system. What does “biopsy” mean? It is a biopsy, which in layman’s terms means that a little bit of tissue is cut out from the patient’s body where there may be disease for laboratory testing to see the nature of the disease before the next step is taken. Seeing its definition, you can know that this operation actually does not require a clean cut of the lesion, as long as a part of it is cut out to complete the task. However, with the improvement of the operation technology, minimally invasive rotary incision has been completely able to remove those lesions of the right size completely. In other words, minimally invasive rotary cut is now not only a biopsy system, but also a treatment system. Because the entire procedure is guided by ultrasound observation, minimally invasive rotary incision has advantages that traditional surgery does not have: small incision, accurate extraction, less trauma, and good aesthetics. However, many patients mistakenly believe that minimally invasive rotary incision is “unclean”, and even some so-called breast surgeons also have this misconception, and intentionally or unintentionally confuse the concepts of “recurrence” and “reoccurrence”. The concept of “recurrence” and “recurrence” is confused, and patients are guided to “open a large incision and cut a small lump”. Here, it is important to clarify the difference between these two concepts. What is “recurrence”? A recurrence can be understood as a failure to remove the lump cleanly and the original area growing back after a period of time after surgery. This is the result of inadequate surgical skills. What is “recurrence”? Recurrence can be understood as the growth of a new lump outside the surgical area, which has nothing to do with the surgical method or technique, but rather with the patient’s own constitution. It is possible to eliminate “recurrence” by a certain surgical method, but impossible to eliminate “recurrence”. Therefore, if the mass “recurs”, don’t blame it on the minimally invasive rotary incision! Even if a large mass is removed, it will “recur” unless all the glandular tissue is cut out, but who would do that? Although minimally invasive rotary surgery is a good technique, it is not suitable for every patient. The following patients are not suitable or less suitable for minimally invasive rotational surgery. (1) The lump is located behind the nipple. Because the surgery may cut off the large milk ducts and affect the lactation function, it is better to use the traditional incision of the areola in this location, and the wound is also aesthetically pleasing. (ii) Ultrasound reveals large blood vessels crossing next to the lesion, because the rotational incision may lead to significant bleeding making the procedure incomplete or increasing the chance of recurrence. (iii) The mass is relatively large. If the longest diameter of the mass is more than 2 cm, because the groove of the minimally invasive rotary incision is 2 cm long, a mass longer than this will be left. Of course, the surgeon can choose to place the rotary cutter in the direction perpendicular to the longest diameter, so that it can also be removed cleanly. However, if every diameter of the mass is more than 2 cm, you are better off with the traditional surgery. ④Patients with high preoperative suspicion of malignancy who require conventional surgery and immediate pathological results. ⑤ Patients with papillary overflow cannot opt for minimally invasive surgery because the entire diseased duct and its glandular tissue have to be removed.