Background <p>Hospital systems must document adherence to strict quality standards to achieve specialty accreditation. Requirements often include completion of quality improvement (QI) projects. Because breast surgeons are often the leaders of the multidisciplinary teams, they are tasked with initiating these QI projects. Although they are comfortable interpreting data in their practices, most breast surgeons lack formal training in quality. This report aims to provide guidance for breast surgeons to initiate and navigate QI projects.</p> Methods <p>The Patient Safety and Quality Committee of the American Society of Breast Surgeons reviewed the literature for relevant resources of surgical quality to establish a framework for surgeons to use when performing QI projects.</p> Results <p>Review of the literature and online sources showed nine key principles breast surgeons should use when performing QI studies. Emerging data, a change in process, or patient/provider feedback can provide potential ideas for study. After creating a problem statement, the stakeholder team defines the current state by obtaining local data and comparing it with established benchmarks. Once a gap is identified, a root cause analysis is performed to determine potential interventions for improvement. Assessment of results after implementation can be used to measure success.</p> Conclusion <p>Quality improvement in breast surgery involves a combined effort between health care staff and stakeholders to improve the care provided to patients. Breast surgeons are well positioned to direct these projects as leaders of the care teams. This report provides a framework for common understanding of the key principles of QI in breast surgery.</p>