AbstractThe potential advantages of conservative breast surgery include the minor outpatient nature of the procedures, lower incidence of postoperative pain and complications, preservation of the breast and nipple areolar complex, and shorter delay to adjuvant therapy. In order to optimize the number of patients eligible for conservative breast surgery, one must utilize a multidisciplinary team approach. Imaging implications, use of neoadjuvant therapy for downsizing tumors, oncoplastic techniques, adjuvant radiation options, and pathological assessment are discussed. J. Surg. Oncol. 2011; 103:306–312. © 2011 Wiley‐Liss, Inc.