الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Breast cancer, according to national cancer institute, is the most common site of cancer in women in Egypt as it accounts for about 38.8% of total malignancies among Egyptian females; it is an important cause of mortality among women.
The goal of modern breast surgery is to cure patients with preservation of breast tissue as much as possible with satisfactory physical and psychological outcome. This goal has led to introduction of a new scope of surgery into our clinical practice called oncoplastic breast surgery, with the advantage of combining oncological safety and satisfactory cosmetic outcome.
Skin-sparing mastectomy combined with immediate reconstruction can provide excellent cosmetic results. This technique preserves the natural skin envelope of the breast while removing the breast, NAC, biopsy scars, and skin overlying superficial tumors. Studies have shown that LR rates for skin-sparing mastectomies are comparable to those of non-skin-sparing mastectomies in patients with non-invasive and early stage breast cancer. This technique is also well-suited for those patients at high risk for developing breast cancer who opt for a prophylactic mastectomy. It is contraindicated in patients with tumors involving the skin. Smoking, previous radiation, diabetes, and obesity can increase the risk of skin envelope ischemia, necrosis, and infection.
Nipple-sparing mastectomy is oncological safe provided that the tumor is no closer than 2 cm from the nipple-areola complex and there are no malignant micro calcifications close to the nipple. In case a nipple-sparing mastectomy is performed, intra operative frozen section analysis of the retro areolar specimen is mandatory and the decision whether or not to excise the nipple area complex depends on the intra- operative result.
Breast reconstruction is becoming increasingly important due to changes in patient expectations and demand. There is growing recognition that immediate reconstruction in appropriately selected women can combine an oncological and aesthetic procedure in one operation with excellent results. Because most breast surgery is performed by general surgeons, most reconstructions were performed as delayed procedures by plastic surgeons. Increasingly, breast surgery is being performed by breast surgeons trained in oncoplastic techniques who can offer immediate reconstruction with both therapeutic and economic option
Post mastectomy breast reconstruction seems to be generally accepted procedure and represents a surgical option that improves psycho social outcome.
Our study is a retrospective study in which 30 patients with breast cancer were followed up for 1 year. Six patients underwent SSM and 24 Patients underwent NSM with very good cosmetic outcome for a relatively large tumor excisions with 66.7% of the cases (20 patients) falling in excellent and very good score, only one of the patients had malignant recurrence. Finally this is proving that skin sparring mastectomy technique is safe from oncological point of view with better cosmetic outcome.