الفهرس 
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Abstract
The development of a standard of treatment that encompasses Breast conservative surgery and Modified radical mastectomy, happened through need and research. Introduction of oncolpastic surgery with a concomitant contralateral symmetrization procedure is now the new surgical approach that would give the surgical oncologist the freedom required for wide excisions hand in hand with the prevention of breast deformities resulting in a proper cosmetic outcome. Objective:To assess the feasibility of bilateral breast reduction for the management of breast cancer and determine the most suitable surgical technique of therapeutic mammoplasty for each patient. Then, Evaluate the cosmetic outcome through out different postoperative phases. Methods: this study included 43 female patients with breast cancer; they were 3 groups; group A; had bilateral superior pedicle reduction mammoplasty, group B; had bilateral inferior pedicle reduction mammoplasty, group C; had bilateral batwing mastopexy. 1 month postop patients were asked to answer a 5 scale questionnaire evaluating their own cosmetic outcome. Criteria they were asked to evaluate were; symmetry, shape and volume, projection, correction of ptosis, visibility of the scars and overall satisfaction. a similar questionnaire was answered by a panel made up of a surgeon and breast-care nurse after seeing pre and post-operative photos of the patients in question. Results: mean age was 47 years, stages were IA (2.326%), IIA (30.233%), IIB (55.814%) & IIIA (11.628%). Group A had a mean tumour size of 2.7 ± 0.6892 cm , least resected margins 1.2 - 4.3cm, Group B had a mean tumour size of 3.2 ± 1.1912 cm , least resected margins 0.7 - 3.8cm, Group C had a mean tumour size of 3.4 ± 1.1204 cm, least resected margins 1.7 - 5.2cm. Mean operative time for group A was 209.8 ± 27.115 mins, for group B was 222 ± 20.053 mins, for Group C was 102.28 ± 16.251 mins. The mean hospital stay for group A was 3.2 ±1.304 days, Group B was 3.25 ±1.02 days,Group C was 1.89 ±0.583 days. Early complications included; wound gapping and delayed wound healing at the T-junction, axillary seroma, superficial areolar sloughing, stitch sinus, minor wound infection and breast seroma and late ones included; hypertrophic scarring, radiation mastitis, fat necrosis and affection of nipple-areola sensation. Cosmetic results fared high above average, also, Group C fared better in overall satisfaction but Group B fared better in Ptosis correction, projection and symmetry. The panel answers showed difference regarding shape and volume; the only two criteria to be almost of the same result among the three groups. Conclusion: Bilateral TM has some advantages when compared to standard conventional BCS techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates. So it is a valuable addition to consider the use of such surgical techniques whenever indicated in the surgical management of patients with breast cancer. Batwing mastopexy showed superiority in operating time, hospital stay and overall satisfaction of patients, surgeons and nurses. Key Words : breast conserving surgery – therapeutic mammoplasty – bilateral mastopexy – breast cancer – oncoplastic surgery – superior pedicle mammoplasty – inferior pedicle mammoplasty – batwing mastopexy.