Introduction: Breast cancer is the most common cause of death in the female population aged 35 to 54, and the second most common cause of cancer death, after lung cancer. The treatment begins with a surgical intervention in the majority of patients. A continuous follow-up of operated patients and the outcome analysis of the used operative therapy are essential since an adequate treatment can contribute to a better quality of life and longer survival. The aim of this study was to determine the role of surgical procedures in the diagnosis and treatment of breast cancer in the population of women treated in the Surgical Clinic of the Clinical Hospital Center Rijeka in the period from 1996 to 2000 by comparing modified radical mastectomy according to Madden with breast conserving surgery (and axillary lymph node dissection ). We also aimed to assess the effectiveness of using „V“-technique breast conserving surgery. This paper analyzed the survival rate of invasive breast cancer patients and the appearance of local and locoregional recurrences, with regard to the stage of the disease and the method of surgical treatment. Achieved results were compared to the recent literature. Materials and Methods: In the1996-2000 period, we analyzed 473 invasive breast cancer patients with a tumor up to 4 cm in diameter who were treated in the Surgical Clinic of the Clinical Hospital Center Rijeka with modified radical mastectomy according to Madden (MRM), with „classical“ breast conserving surgery (BCS), or with „V“-technique breast conserving surgery. In all breast conserving operations we performed axillary lymph node dissection. The overall survival rate in patients with invasive breast cancer was analyzed with regard to the stage of the disease and the type of operation. Special attention was paid to the analysis of surgical procedures depending on different variables and their impact on the appearance of locoregional recurrence. Statistical evaluation of data was done in the programme ″SPSS 16.0 for Windows″. Results: According to our study, a five-year overall survival was 76.96%, and a eight-year overall survival was 63.85%. In patients treated with breast conserving surgery a five-year overall survival was 84.56%, and 73.46% (p = 0.001) in patients operated on by modified radical mastectomy. The comparison of surgical methods in patients with the same T and N stage showed no differences either in the survival rate or regarding the histopathological grade of the tumor and steroid receptor status. The overall local and locoregional recurrence rate during the eight-year period was 10.99%. There was no statistical significance in the appearance of local or locoregional recurrences in the comparison of the applied surgical procedures (p = 0.866). In the T2 and N stages of cancer and in the cases with involved lymph nodes, local and locoregional recurrences were more frequent in breast conserving surgery compared with modified radical mastectomy. In comparison with „classical“ BCS, „V“-technique was used more frequently in larger tumors (pT2, p<0.05), involved axillary lymph nodes, and in localization of tumor in the lateral quadrants of the breast (p<0.01). Conclusion: The results obtained are in a good correlation with literature data. Our results demonstrate that dimensions of the primary invasive cancer and the number of involved axillary lymph nodes are key factors in clinical estimation which operation (MRM or BCS) to apply. „V“-technique was used more frequently in larger tumors (pT2), involved axillary lymph nodes (pN1, pN2, pN3) and in localization of tumor in the lateral quadrants than "classical" breast conserving surgery. As shown in the example of ″V″- technique rotational flap of breast tissue in breast cancers, ″oncoplastic″ surgical methods enable breast conserving surgery to be performed even in cases when classical conserving operations do not permit it. In addition, our results demonstrate that dimensions of the primary invasive cancer and the number of involved axillary lymph nodes are key survival factors, regardless of the surgical procedure. The ″round block″- technique in the treatment the multicentric fibroadenomas enables the excision of all lesions through one cut and yields an excellent aesthetic result.