Breast reconstruction is nowadays integral part of the treatment of breast cancer. When it is proposed as an immediate reconstruction, the plastic surgeon has to deal with several constraints. The coverage of the patients that must benefit from a mastectomy is complicated by additional treatments of radiotherapy. We propose, in this work, a multidisciplinary splitting of the patients into specific subgroups. An immediate reconstruction will be proposed to certain patients considering the adjuvant radiotherapy. The choices of orientation are complex and a scarce literature on this subject does not allow us to guide in a systematic way all the patients. More studies, with a prospective design, are necessary to guide the patients wishing an immediate reconstruction associated with a radiotherapy after mastectomy.