So-called "scarless" surgery in the treatment of breast cancer consists of a group of procedures with a double aim: local control of the oncological process and maintaining the body image of the woman by making incisions that will not be visible. This article describes four approach routes for scarless surgery (periareolar, axillary, submammary, lateral chest) in different contexts of the oncological breast disease. The application of these incisions in the conservative treatment of breast cancer requires making a wide subcutaneous dissection over the tumour location, and a local reconstruction with adjacent breast tissue, so as not to deform the breast contour, as well as moving the nipple with its areola, thus avoiding the surgical modification of the other breast to maintain symmetry between both. We describe the use of hidden incisions to perform mastectomies that try to conserve as much skin as possible, together with the nipple, as well the dissection, with the aid of an endoscope of the latissimus dorsi muscle, in the immediate breast reconstruction.