**Abstract**

Within the multimodal treatment, the extent of surgery for early-stage breast cancer treatment may be safely de-escalated. This strategy is associated with less morbidity, therefore significant improvements in quality of life (QoL). Nevertheless, conventional, ablative-only breast conservative surgery (BCS) has several limitations considering breast aesthetics and may impact QoL just opposite than anticipated. The concept of oncoplastic breast conservation emerged at the end of the last century intending to overcome these limitations. Although the primary goal remains oncological safe cancer resection, the enhanced aesthetic outcomes, achieved with this approach, significantly contribute to higher patient satisfaction. The author believes that mastectomy should no longer be offered as an equivalent treatment option for early-stage breast cancer patients with low-volume breast disease, irrespective of the availability of postmastectomy breast reconstruction. Moreover, with the opportunities of oncoplastic breast conservative surgery, the technical feasibility of breast conservation should not represent an issue even in a higher stage of the disease. Clinical decision on the type of oncoplastic procedure is mainly based upon the anticipated percentage of breast volume loss and the residual breast volume, as well as the availability of additional donor sites, patients' preference, and surgeons' skills.

**Keywords:** breast cancer, surgery, mastectomy, breast conservation, oncoplastic, quality of life
