Malignant melanoma of the breast (MMB) is a rare disease that accounts for 3-5% of all melanomas. It can be expressed as a metastatic mammary gland or primary mammary melanin of the mammary gland. Primary MMB (PMMB) can be divided into two types: parenchymal melanoma without skin involvement and melanoma involving skin on the breast. The diagnosis of PMMB relies mainly on histopathological diagnosis. In this diagnostic approach, S100 and HMB45 have a higher specificity in the diagnosis of melanoma immunohistochemistry. At the same time, mutations in the BRAF (V600E) gene have further aided the diagnosis of PMMB. After the diagnosis, the main treatment is mainly based on surgery. The main surgical methods include breast-conserving surgery and mastectomy. With advances in technology and surgical skills, the combination of patient aesthetic satisfaction and tumor safety is the goal of modern breast surgeons. This article reviews the current status of PMMB surgical treatment.