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During the last century, the understanding of pathogenesis and tumor biology of breast cancer have been improved and adjuvant therapy has been developed. Therefore, the surgical procedure has become less aggressive and less invasive for ameliorating cosmetic outcome and quality of life, without interfering with oncologic safety. The procedures for breast cancer surgery were changed from radical mastectomy to be modified radical mastectomy, skin sparing mastectomy or nipple sparing mastectomy with or without reconstruction and breast conserving surgery, respectively. A traditional axillary lymph node dissection is replaced with sentinel lymph node biopsy, a procedure used to identify the spread of cancer to the first lymph nodes. The selection of an appropriate surgical procedures for personalize treatment depends on cancer stage, patient’s desire, indications and contraindications.