Abstract:

Whether applying adjuvant treatment including radiotherapy， chemotherapy and endocrine therapy after traditional surgery， or performing neoadjuvant therapy to achieve debulking， breast and axillary lymph node conservation， surgery is always primary treatment for breast cancer. In recent years， an increasing number of researches have focused on precision surgical treatment， in order to realize minimal surgical incision and maximal clinical benefit at the same time. Therefore， this article summarized the top ten hot issues in surgical treatment of breast cancer， including concept innovation of breast conservation， definition of breastconserving surgery margins， breast conservation of germline BRCA mutation patients， breast-conserving surgery after neoadjuvant therapy， feasibility of surgery exemption after neoadjuvant therapy， exemption of sentinel lymph node biopsy， treatment of low-burden metastases in sentinel nodes， de-escalation therapy of axillary nodes after neoadjuvant therapy， local treatment of newly diagnosed stage Ⅳbreast cancer and minimally invasive surgery such as endoscopic and Da Vinci-assisted robotic surgery， in order to provide a refence for precision and standardization of surgical treatment in the future.

Key words: Breast neoplasms, Neoadjuvant therapy, Sentinel lymph node, Breast-conserving surgery, De-escalation treatment