Objective To explore the effects of breast-conserving surgery (BCS), simple mastectomy (SM), and modified radical mastectomy (MRM) on early postoperative upper limb motor function, physical function and psychological status in breast cancer patients.

Methods A cross-sectional study design was employed. A total of 212 female breast cancer patients undergoing surgery at the Department of Breast Surgery of Zhangzhou Affiliated Hospital of Fujian Medical University from October 2024 to December 2025 were enrolled. Patients were divided into the BCS group (n＝34), SM group (n＝79), and MRM group (n＝99). General demographic and clinical data were collected. At 3–7 days postoperatively (window period), the Constant-Murley score (CMS), active range of motion (AROM) of the shoulder joint, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were used to assess upper limb function; the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate psychological status, quality of life, and sleep quality.

Results The total CMS score, pain score, and range of motion score in the BCS group were higher than those in the SM and MRM groups (P＜0.05). The BCS group showed greater forward flexion range of motion than the SM and MRM groups (P＜0.05); and the SM group showed smaller internal rotation range of motion than the MRM and BCS groups (P＜0.05). The PHQ-9 depression score in the BCS group was significantly higher than that in the MRM group (P＜0.05). There were no statistically significant differences among the three groups in QuickDASH, GAD-7, FACT-B, or PSQI scores.

Conclusions Breast cancer patients undergoing different surgical procedures exhibit differences in postoperative physical function and psychological status. BCS can better preserve early postoperative upper limb function but may be associated with a certain tendency toward depression.