The current strategy of surgical treatment in patients with breast cancer (BC) is directed to ensuring a reliable cure and to creating conditions for breast reconstruction. A total of 437 patients with BC underwent reconstructive plastic surgery as part of combination treatment: organ-sparing surgeries were performed in 173 patients via single-stage lost volume reconstruction replacing with extramammary breast tissues, in 117 patients through reduced mammoplasty procedures transferring volume deficit with intrinsic breast tissues, and in 147 via subcutaneous mastectomy preserving the nipple-areola complex (NAC). Based on the findings, reconstruction methods were arbitrarily arranged in the following order: organ-sparing with breast tissue volume transfer and replacement, endoprosthetic reconstruction after subcutaneous mastectomy with preservation of NAC, and/or its combination with a muscle thoracodorsal graft, and the use of the muscle pedicle TRAM flap. An algorithm was developed to choose reconstructive plastic operations in the surgical treatment of patients with BC. The follow-up period was 3.9 to 127.8 months, averaging 28 months. The follow-up of 437 patients showed the progression of the underlying disease in 95 (21.8%), of them 30 (6.9%) patients were observed to have a local recurrence and 65 (14.9%) had distant metastases.