早期乳腺癌保乳手术已成为一成熟技术。文中探讨保乳术后局部复发的因素。对保乳手术后局部复发低危病例是选择部分乳房放疗的适应证。对腋淋巴结阴性者,前哨淋巴结活检替代腋清扫初步报道效果满意。乳房切除后,各种类型的乳房重建是乳腺癌根治术后改善病人生存质量的重要部分。微创治疗尚有射频消融技术,适合Ⅰ期病例,现处临床试验阶段。腔镜下腋淋巴结清扫创口小,对肿瘤的局部控制、病人生存率和生存质量的影响尚需进行前瞻性临床试验研究。 Early breast conserving surgery has become a mature technology. The article discusses the local recurrence after breast-conserving factors. Low-risk local recurrence after breast-conserving surgery is the indication of choice of some breast radiotherapy. Negative axillary lymph nodes, sentinel lymph node biopsy instead of axillary dissection reported initially satisfactory results. Breast resection, various types of breast reconstruction is an important part of improving the quality of life of patients after radical mastectomy. Minimally invasive treatment is still radiofrequency ablation technology, suitable for stage Ⅰ cases, is now at the clinical trial stage. Endoscopic axillary lymph node dissection small wounds, the local control of the tumor, the survival rate of patients and the quality of life still need to conduct prospective clinical trials.