The same disease, in different individuals, at different stages, according to the current treatment guidelines, there are different treatment options for patients to choose from. This requires good professionalism and patient expression and explanation from the doctor, as well as sufficient trust and understanding from the patient. Today’s and tomorrow’s surgeries are both for breast cancer patients in their early 40s. Today’s patient underwent a simple tumor resection at an outside hospital, without preoperative hollow needle aspiration or intraoperative frozen section examination, and the postoperative plan was a relatively simple but still effective surgical approach of modified radical surgery (excision of the whole breast on the affected side + axillary lymph node dissection). When her family came to me for consultation, I reviewed the information and suggested the next step: 1. mammography or MR examination to find out whether there are other suspicious lesions; 2. if there are no other lesions, an enlarged local excision should be performed and the frozen section should be examined for residual cancer at each margin. If there is still cancer residue, breast conservation is abandoned.3. If there are no enlarged lymph nodes in the axilla on the affected side during clinical physical examination (palpation by the doctor), biopsy of the anterior lymph nodes can be performed, and if there is lymph node metastasis, the axillary lymph nodes will be cleared; if no metastasis is found, the axilla will be preserved. This is the approach recommended by the NCCN (National Comprehensive Cancer Network) guidelines, provided that the patient is willing to preserve the breast. There is no significant difference in local recurrence rate, tumor-free survival time and overall survival between radical breast-conserving surgery and axillary preservation with negative anterior lymph node biopsy compared to previous single modified radical surgery (excision of the whole breast on the affected side + axillary lymph node dissection). Department Introduction Breast Surgery Department of Nanhai Maternal and Child Health Hospital, Foshan District, Guangdong Province is a recent key development of our hospital. It is the government-designated unit in charge of breast cancer screening and personnel training in Nanhai District, and this year was awarded the license to become the Foshan Nanhai Branch of the Breast Disease Prevention and Treatment Center of Guangdong Provincial Maternal and Child Health Hospital. With good professional knowledge and skills and “people-oriented” service concept, we provide women with integrated and professional services of breast disease diagnosis and treatment, breast cancer screening, diagnosis, treatment and lifelong follow-up. Equipment configuration and professional staff Nanhai Maternal and Child Health Hospital has advanced breast surgery equipment, including GE molybdenum rhodium double target camera (the only molybdenum target machine equipped with three-dimensional positioning VAB vacuum-assisted breast biopsy system in the five districts of Foshan), TOSHIBA Aplio 500 color high-frequency ultrasound (the first one introduced in Foshan City, which can observe microcalcifications in the breast with firefly technology and can observe breast lesions with elasticity) and TOSHIBA Aplio 500 color high-frequency ultrasound. TOSHIBA Aplio 500 color high-frequency ultrasound (the first ultrasound machine in Foshan to observe breast lesions and glandular hardness using firefly technology and elasticity imaging), portable color ultrasound for census, EnCor vacuum-assisted breast biopsy system, BLADE breast duct endoscopy, Matilda fluorescence pulsed duct (sentinel lymph node) detector, BARD hollow needle puncture needle and other specialized testing and surgical equipment. At present, the department has one associate professor and one associate chief physician, two masters, one attending physician and two residents. Now there are 15 beds, about 7,000 outpatient visits per year and 500 inpatient visits per year. The annual breast cancer screening is about 10,000. The medical team of the Breast Surgery Department has rich experience in the diagnosis and treatment of breast diseases and is engaged in clinical work all year round. They can perform any breast-related diseases, such as nipple overflow, breast cancer early diagnosis, standardized and individualized treatment of breast cancer; they can perform breast disease-related surgeries, including hollow needle aspiration biopsy of breast lesions, minimally invasive biopsy, molybdenum targeting biopsy of microcalcified lesions, minimally invasive excision of breast fibroids, modified radical surgery of breast cancer, breast cancer Breast-conserving surgery, breast cancer sentinel lymph node biopsy, post-operative breast cancer reconstruction, as well as breast cancer chemotherapy, endocrine therapy, biological targeting and other comprehensive treatments. In recent years, precision medicine has been introduced. Our department provides tailor-made treatment plans for each patient who comes to our clinic, for example: different treatment plans are provided according to the location and size of breast tumors: minimally invasive surgery is recommended after hollow core needle aspiration to get benign evidence, which can get rid of lesions and still keep beautiful without leaving scars. Even for patients with confirmed breast cancer, not just everything is done. Radical breast-conserving surgery that meets the requirements of the US NCCN guidelines can be offered to patients who need to qualify for breast conservation with adequate evaluation. Breast-conserving radical surgery with preservation of the axilla can also be performed if no metastasis is seen on biopsy of the anterior lymph nodes. In addition, our breast surgery department has made certain features in minimally invasive surgery: minimally invasive surgery for benign tumors requires only one tiny incision on one side of the breast, even if there are 7-8 lesions on one side, no additional incisions are required. Most of the incisions utilize physiological folds, which are well concealed and the scars are difficult to detect. For benign tumors larger than 3 cm that are not suitable for minimally invasive surgery, we use the small incision-assisted EnCor system, which can also remove larger tumors with a smaller incision. This method has been used in our department to successfully remove benign breast tumors of about 9 cm in diameter. For breast abscesses, our department uses minimally invasive surgical placement of ducts for drainage, again with much smaller scars than conventional procedures, to achieve good treatment results. For the recent increasing incidence of non-puerperal mastitis, our department has received many patients who had ulcers that did not heal after long-term treatment and were cured after conservative and surgical treatment. In short, we pursue to be thoughtful and compassionate surgeons, and it is our unremitting goal to provide our patients and friends with satisfactory treatment plans and achieve good treatment results. The life is often the free tumor cells latent in the blood circulation and lymphatic circulation, and these cannot be solved by removing all the breast or one side of the armpit, even expanding the removal of pectoral muscle and so on, but need systemic treatment such as chemotherapy, endocrine and targeted therapy to deal with them. Radiation therapy must be performed after breast-conserving surgery. After repeated consideration, the patient and her family requested breast conservation and axillary preservation. The preoperative examination of mammogram and MR were free of other suspicious lesions. Today, we applied a domestic Minute Maid fluorescence detector and performed a biopsy of the sentinel lymph nodes with indocyanine green ICG+Melan double marker. The results were negative for tumor margins and sentinel lymph nodes, and the breast-conserving and axillary surgery will be completed when there are no abnormal findings in paraffin sections. The patient for tomorrow’s surgery was different in that in addition to the palpated medial breast tumor, ultrasound revealed 4 additional non-palpable masses, and the preoperative punctured tumor and at least one non-palpable mass were both invasive ductal carcinoma. It is not suitable for breast conservation, but the tumor is located medially and the possibility of metastasis to the axilla is lower than that of upper quadrant tumors, so biopsy of the anterior lymph nodes is a good way to avoid excessive surgical trauma “killing the innocent”. The whole treatment of breast cancer has shifted from “the largest amount of treatment the patient can afford” to “the smallest amount of effective treatment for the tumor” in the last century; according to the tissue classification, size, location, stage, and staging of the tumor, we can carefully analyze and provide a solution for the unfortunate patients. Together, we can provide the most suitable “personalized” surgery, chemotherapy, radiotherapy, endocrine, targeted, immunotherapy, etc. for the unfortunate patients, which is the direction of individualized and precise treatment advocated by WHO.