الفهرس 
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Abstract
SUMMARY
Breast cancer is the second most common cancer among women and the second leading cause of death secondary to cancer. Techniques that are used in treatment of this disease have evolved through the years to eradicate the tumor cells completely while restoring the patients’ pre-disease state. Although it was proved that breast conserving surgery was a reliable option, most patients prefer mastectomy accompanied with breast reconstruction.
Breast conservation therapy preserve the breast and often reduces the demand for reconstruction of postmastectomy defects. Some women undergo partial mastectomy with radiation and maintain excellent breast symmetry and contouring. Others show more noticeable deformities that might require secondary revision or completion mastectomy with reconstruction.
Breast reconstruction has become an integral aspect of breast cancer management. It can be done safely and effectively. Timing of breast reconstruction after mastectomy involves many factors that are important in choosing between two options immediate or delayed reconstruction.
A spectrum of techniques is available from which the patient and surgeon can choose. These techniques can involve breast implants, autologous tissue, or both. Implant based techniques are a simple and effective method of breast reconstruction, but they may not be suitable for all patients, particularly those who need or have had radiotherapy. Autologous methods in contrast are more surgically demanding, but they consistently yield better aesthetic results than non-autologous methods, particularly when combined with skin sparing mastectomy.
Each surgeon should discuss with the patient about the advantages and disadvantages of all methods of breast reconstruction to assist her to determine the most appropriate one. The main point is that all women who have undergone mastectomy should be offered reconstruction in case it meets their personal needs and alleviates some of the psychological strain of malignancy.
Nipple reconstruction is an important component of breast reconstruction; the nipple and areola transforms the reconstructed mound into a breast. When breast reconstruction is done correctly and the nipple-areola reconstruction is attractive, the overall result is pleasing and natural.
Once the decision to perform a contralateral symmetry procedure has been made, the surgeon has several options. In majority of situations, the operation will involve a reduction or augmentation mammoplasty.
Further surgeries can be done to improve the volume and contour symmetry of the breasts; scar revision including that of donor sites; further areolar tattooing and secondary procedures to improve nipple height.
Both implant and autologous tissue reconstructive techniques have been proven to be safe oncologically.
Breast cancer can recur with or without reconstructive surgery so, long-term survival is not altered by the reconstructive breast surgery.