Recent developments in the management of breast cancer, including axillary sentinel lymph-node biopsy, as well as the inability to reliably detect micrometastatic disease in the axillary lymph nodes either preoperatively or intraoperatively, and the increasing use of both postmastectomy radiation therapy and neoadjuvant chemotherapy, have had a significant impact on the timing of breast reconstruction. The interplay and sequencing of these diagnostic and treatment modalities in patients with breast cancer have become important issues. This article addresses the clinical dilemma of determining the appropriate timing of breast reconstruction based on various patient-related clinical and pathological factors.