Michael Gnant, MD, Medical University Vienna, Vienna, Austria, discusses optimal surgical strategies for patients with breast cancer as evaluated at the virtual 17th St. Gallen International Breast Cancer Conference. Dr Gnant highlights the importance of developing detailed algorithms for surgery of the breast and axilla, including ongoing themes of de-escalation of surgery, tailoring surgery following neoadjuvant treatment as well as the role of mastectomies in patients with breast cancer. This interview took place during the 17th St. Gallen International Breast Cancer Conference.