Background: Breast cancer has a significant concern in modern researches due its mortality and associated psychological aspects. Aim of the Work: The aim of this work is to compare conservative breast surgery (CBS) and modified radical mastectomy (MRM) regarding oncologic and cosmetic outcomes in women with primary breast cancer negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 triple-negative breast cancer (TNBC). Patients and Methods: This retrospective study included 20 patients presented by breast cancer. All patients underwent surgery at Al-Azhar University Hospitals. 10 patients were treated by conservative breast surgery and 10 patients were treated by modified radical mastectomy. Results: We investigated Overall Survival in patients with TNBC treated with mastectomy compared with those receiving CBS. The analysis indicated that patients with CBS had better survival than patients with mastectomy in Overall Survival (P < 0.001). Conclusion: patients with CBS exhibited improved in TNBC may be associated with the baseline characteristics between two groups. Most patients in the CBS group presented with better survival than did patients in the mastectomy group. CBS was favored over mastectomy.