There are two methods to treat cancer breast surgically while preserving the NAC. These are nipple sparing mastectomy with immediate reconstruction and breast conservative therapy (BCT) using oncoplastic procedures. Few studies compare both methods directly. This is especially important in the Egyptian population, due to different tumour biology, different radiotherapy technique, and different body habitus. The goals are to compare NSM with autologous reconstruction versus oncoplastic breast surgery regarding the aesthetic and oncologic outcome.