Neoadjuvant chemotherapy and oncoplastic surgery have reduced the indications for mastectomy without compromising either overall or relapse-free survival. Conservative surgery is appropriate, but not when it produces poor esthetic results that are difficult to correct after radiotherapy. The permanent goal of better esthetic results after conservative surgery must never compromise effective cancer management, which is the principal factor to consider. We must, above all, aim at in sano surgery, that is, tumor-free resection margins. Oncoplastic surgery makes it possible to enlarge the indications for conservative treatment to indications previously treated by mastectomy, without increasing adverse cosmetic effects or jeopardizing cancer management and the likelihood of cure. While some authors use the term "oncoplastic surgery" to describe conservative surgical management, other teams define it as oncology surgery plus plastic surgery. Reconstructive surgery of the breast is an integral part of breast cancer treatment. Multidisciplinary decision-making and honest information to patients are essential before any reconstructive surgery.