In the USA, 80% of patients with breast cancer are treated by community breast surgeons. NCDB data indicate that there are only small differences in outcomes between lower volume cancer programs and higher volume programs. There is some evidence that breast cancer patients of high-volume breast focused surgeons may have improved outcomes. This article discusses the challenges community breast surgeons face and some ways that the quality of care could be monitored and improved. Quality reporting programs of the Commission on Cancer and Mastery of Breast Surgery Program of the American Society of Breast Surgeons are recommended as tools to track and improve outcomes in breast cancer care.