Aim: Skin sparing mastectomy (SSM) with immediate reconstruction has been approved to be safe treatment approach for early-stage (T1 or T2) breast carcinoma. This prospective study was undertaken to assess both the feasibility and oncological safety of SSM in patients with large tumor breast cancer. 
Methods: Twenty patients with large T2 and T3 breast cancer were included. All patients were subjected to (SSM) with 
immediate reconstruction with either Transverse Rectus Abdominis Myocutaneous (TRAM) flap or Latissimus Dorsi (LD) 
myocutaneous flap with an implant. The patients were followed up for a period ranged from 12-22 months with a mean of 14.55±2.96 months. 
Results: The mean tumor size was 5±0.73 cm (range 4-6cm). Postoperatively, 3 cases (15%) developed necrosis of a part of their native skin flaps, one case (5%) had partial TRAM flap necrosis, and 5 cases developed seroma. All cases received 
postoperative chemotherapy that was initiated in a mean of 21.5±7.87 days, then radiotherapy after chemotherapy 
completion. Throughout the follow up period, none of the patients developed local recurrence while only one case (5%) 
developed distant bony metastases. 
Conclusion: SSM is feasible and oncologically safe in large tumor breast cancer; however, longer period of follow up is 
required.