Breast surgery is the surgical treatment of breast diseases. Its fields of application are particularly breast cancer therapy and the plastic-reconstructive time that follows. Oncological surgery is one of the most important stages of breast cancer therapy. The history of breast interventions, known since ancient times, has been marked by several moments coincident with the evolution of medical knowledge and with some important discoveries in this field. After thousands of years, this allowed for a type of intervention that, in the utmost respect for physical integrity, offers women a concrete chance of healing. The outcome of breast cancer surgery, with respect to cosmetic results, loco-regional control, and prognostic information from nodal staging may vary substantially. Optimal breast cancer care starts with a proper surgical act, which can only be performed when optimal imaging and preoperative diagnosis are available. Next, on the basis of all perioperative findings, the right surgical procedure should be indicated after multidisciplinary consultation and discussion, keeping the objective of the final outcome in mind. The surgical act itself is best performed by an experienced surgeon who has maintained their experience after sufficient training. The outcome of the different procedures can be measured according to simple criteria and prospective registration.