Surgery remains an essential step in the treatment of breast cancers, which are mostly diagnosed at early stages thanks to the screening. The evolution of breast cancer surgery is heading for a de-escalation in accordance with scientific data and patient expectations in terms of quality of life. At the mammary level, the evolution towards a conservative surgery is reinforced by complex surgical techniques (oncoplasty) and systemic neoadjuvant treatments. At the ganglionic level, sentinel lymph node dissection progressively replaces axillary dissection without loss of chance for the patients, making it possible to reduce the axillary morbidity. The place of breast reconstruction is growing although a majority of patients do not carry it out. Works need to be continued to understand this rate (less than 30% of patients). Failure of information? Fear of relapse? Medical misunderstanding?
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