ObjectiveThe aim of this study is to investigate the impact of primary tumor location on the prognosis of breast cancer patients undergoing breast-conserving surgery. MethodsPatient data were retrospectively collected from medical records of individuals who underwent breast-conserving surgery at the Affiliated Hospital of Southwest Medical University between January 2018 and December 2019. ResultsA total of 148 patients were included in this study. The distribution of tumors by location was as follows: the upper outer quadrant accounted for 52.0% (77/148), the lower outer quadrant for 14.2% (21/148), the upper inner quadrant for 14.9% (22/148), the lower inner quadrant for 12.1% (18/148), and the central region for 6.8% (10/148). No statistically significant differences were observed in the comparison of clinicopathological characteristics among breast cancer patients with tumors at different locations (P>0.05). The survival analysis revealed significant correlations between patient prognosis and tumor location, size, molecular classification, WHO grading, as well as endocrine and radiotherapy treatments. Patients with tumors located in the upper inner quadrant [HR=4.400, 95%CI(1.282, 15.099), P=0.019], lower inner quadrant [HR=4.400, 95%CI(1.282, 15.099), P=0.019], and central region [HR=5.238, 95%CI(1.174, 23.361), P=0.030] exhibited significantly higher risks of 5-year recurrence and metastasis compared to those with tumors in other locations. ConclusionsThis study indicates that primary tumor location in the inner quadrants and central region is associated with an increased risk of recurrence and metastasis in breast cancer patients following breast-conserving surgery, representing potential risk factors that warrant attention in clinical decision-making.