الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cancer breast has a catastrophic impact on general health care organizations and is considered one of the leading causes of morbidities and mortalities among the feminine side of the community
Over many years, authors developed many modalities to cure cancer breast starting from total radical mastectomies till evolution of science reached oncoplastic techniques with the aid of adjuvent therapy. As a result of such evolution, cancer breast patients started to look for good aesthetic outcomes together with complete cure from cancer.
In addition to being equivalent to mastectomy in terms of oncological safety, Oncoplastic surgery offers advantages over mastectomy in terms of quality of life and esthetic outcomes. Quality of life after breast surgery is affected be preservation of breast, avoiding donor site morbidity, cosmetic results, treatment duration, and convenience. All of these factors must be considered in assessment of a patient who appears to be an appropriate candidate for oncoplastic surgery.
Oncoplastic breast surgery preserves the breast, which has several benefits, including preservation of the original shape and skin of the breast, preservation of sensations and psychological advantage associated with breast preservation.
Oncoplastic techniques carries two modalities: volume replacement and volume displacement techniques. The used modality depends on the volume of the breast, type, size of the malignant mass. Volume displacement techniques depend on the remaining breast tissues to restore the aesthetic look of the breast. In order to ensure good aesthetic outcome with minimal wound complication, surgeons should use tissues with good vascularity. This raise the interest to localize the main feeding vessels of the breast and use them to create well vascularized NAC flaps to be used in reconstructions.
Many breast vascular imaging modalities has been used over years: HHD, CTA, MRA and others. In our study, we used MRA to localize the main vessels of NAC, as most of malignant tumor are investigated routinely using MRA in our institue. MRA gives valuable information about the site, size and nature of malignancy and also gives good idea about the amount of excision. It provides also precise information regarding the main vessels of the breast. We designed our reconstruction flaps depending on information provided by MRA.
The use of MRA in reconstruction provided a safe way to do total tumor excision and reconstruction with minimal wound complications to avoid delay of starting adjuvant therapy together with good aesthetic outcomes.