الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study aimed to : The breast is symbol of femininity and maternity. Radical mastectomy associated with several complications especially well known-mutilation. In the past 20 years, breast conservation has become the treatment approach for breast carcinoma preferred by surgeon and patient alike. However traditional breast conserving therapy (BCT) also associated with some complications as fat Necrosis. In our study we classified the cases into two groups: Group (I): included 48 patients who underwent oncoplastic breast surgery between December 2013 to December 2014. They were subdivided into two subgroups: Subgroup (IA): included 28 patients who underwent oncoplastic volume displacement breast surgery Subgroup (IB) : included 20 patients who underwent volume replacement techniques by immediate latismusdorsi breast reconstruction after Skin Sparing Mastectomy (SSM); or Nipple Sparing Mastectomy (NSM). Group (II) : included 48 patients who underwent oncoplastic breast surgery between December 2005 to December 2013. They were subdivided. They were subdivided into two subgroups: Subgroup (IIA) : included 28 patients who underwent oncoplastic volume displacement breast surgery by the same technique as subgroup IA. Subgroup (IB) : included 20 patients who underwent volume replacement surgery by the same technique as subgroup IB. Oncoplastic volume displacement breast surgery was done by : Wide local excision & glandular redistribution, lateral mammoplasty, medial mammoplasty, inferior pedicle, bipedicled mammoplasty and Grissoti flap. Immediate reconstruction with latissimus dorsiflap is done by skin sparing mastectomy (SSM); or Nipple Sparing Mastectomy (NSM). In all patients operative specimen marking was done for frozen section and the tumor cavity was clipped to enable postoperative localization of the original tumor bed to facilitate postoperative radiotherapy. All patients were subjectively and objectively evaluated for cosmetic outcome. Subjective assessment was done by patient’s self-assessment questionnaires and by a 3-member panel. Objective assessment was done by breast Retraction assessment, nibble deviation assessment ; and breast volume assessment. Most of ladies who choose breast reconstruction were younger, had higher education levels, occupation chances, marriage status, and higher supportive relation with partner than those who not prefer it. Surgical complications improved at late follow up period apart from restricted activities that was in LD breast reconstruction and partially improved in late time. Patients after oncoplastic conservative surgery were more satisfied compared to patients after oncoplastic reconstructive breast surgery by LDF as regard cognitive, emotional, physical, role, social functions, breast size, shape, symmetry, scar appearance, and sexual well-being ; and late satisfaction in patients with immediate breast reconstruction with LD were significantly more compared to early satisfaction. Panel –assessment of patients underwent oncoplastc conservative breast surgery were more satisfied compared to patients underwent LD breast reconstruction as regard breast volume, ptosis, nipple-areola position, shape, contour deformity, scar appearance, and skin changes ; and late satisfaction were better compared to early satisfaction. Excision of ≥ 10% of breast volume excised decrease the cosmetic outcome. Body distress is much more after reconstruction by LDF than after oncoplastic breast surgery.