Breast nodules graded 4A suggesting malignancy should be considered for surgical biopsy or aspiration biopsy to clarify the nature of the nodule before deciding on the subsequent treatment. Breast nodule grade 4A suggests malignancy, usually need breast ultrasonography to clarify the location of the nodule, and then perform mastectomy, in which the excised nodule will be examined by frozen pathology, and the nature of the nodule can be clarified in half an hour under normal circumstances. Alternatively, a localized biopsy can be performed to determine the nature of the lump. If the nodule is benign, the incision will be closed and the operation will be completed. If the nodule is malignant, further surgery may be required, and commonly used surgical procedures include breast-sparing mastectomy, modified radical mastectomy, and radical mastectomy. If breast nodules 4A are clearly present, active treatment is recommended to avoid adverse consequences from the progression of the disease.