Conservative therapy of invasive breast cancer by tumorectomy or quadr
antectomy followed by radiation of the remaining breast tissue is very
common since 15 years. However, more than 10% local recurrences will
occur within a 10-year follow-up. Skin-preserving or extended subcutan
eous mastectomy, i. e. total removal of the mammary gland, is an alter
native to breast-conserving surgery and radiotherapy. In primary breas
t reconstruction silicone implants, permanent expander prostheses or a
utogenous tissue are used. The incidence of 4.7% local recurrences aft
er a 10-year follow-up supports the extended subcutaneous mastectomy w
ith primary reconstruction as an adequate therapy for breast cancer.