Surgical care has been the mainstay of breast cancer diagnosis and treatment. As care has evolved, increased collaborative approaches among surgeons, radiologists, radiation oncologists and medical oncologists have improved the quality of breast cancer treatment for the patient. Breast conservation therapy (BCT) exemplifies how multi-specialty care can increase cancer cure rates at the same time that the disfiguring aspects of breast cancer treatment can be minimized. New questions are being raised within clinical forums about how to do better both for the patient and for her oncologic treatment. The following questions represent three current issues in BCT: 1. What general operative approaches in BCT can minimize morbidity and optimize the cosmetic outcome from surgery? 2. What role does radiation therapy play in BCT for invasive and non-invasive breast cancer to supplement surgical intervention? 3. What role can neoadjuvant chemotherapy play in improving BCT rates?