Breast reconstruction should be regarded as a significant part of breast cancer treatment. Immediate reconstruction has the advantages of a better cosmetic result, a better illness approach and of avoiding the need of a second major operative procedure. Immediate and early delayed reconstruction does not significantly increase the risk of local or systemic disease recurrence and the type of surgery performed should depend on the further therapy chosen. Skin-sparing mastectomy--a new technique--preserves the skin envelope and should be proposed to patients with central breast cancer.