Annals of Surgical Oncology

, Volume 9, Issue 2, pp 165–168

Analysis of nipple/areolar involvement with mastectomy: Can the areola be preserved?


    • Department of SurgeryWeill Medical College of Cornell University
    • The New York Presbyterian Hospital
  • Meghan Brennan
    • Strang Weill Cornell Breast Center
  • Paul Christos
    • Department of Public HealthWeill Medical College of Cornell University
  • Valencia King
    • Weill Medical College of Cornell University
  • Michael Osborne
    • Department of SurgeryWeill Medical College of Cornell University
    • The New York Presbyterian Hospital
Original Articles

DOI: 10.1007/BF02557369

Cite this article as:
Simmons, R.M., Brennan, M., Christos, P. et al. Annals of Surgical Oncology (2002) 9: 165. doi:10.1007/BF02557369



Skin-sparing mastectomy (SSM), which involves the resection of the nipple/areolar complex with the breast parenchyma, improves the aesthetic outcome for breast cancer patients. Most patients undergoing SSM desire reconstruction of the nipple/areolar complex for symmetry. These data explore the possibility of preserving the areola in selected mastectomy patients.


A retrospective analysis of 217 mastectomy patients was conducted to determine the frequency of malignant nipple and/or areola involvement. The association between nipple and/or areola involvement and prognostic factors, including tumor size, stage, nuclear grade, axillary nodal status, and tumor location, was evaluated.


The overall frequency of malignant nipple involvement was 23 of 217 (10.6%). In a subgroup of patients with tumors <2 cm, peripheral tumors, and with two positive nodes or less, the incidence of nipple involvement was 6.7%. When the nipple and areolar involvement were analyzed separately, only 2 of 217 patients had involvement of the areola (0.9%). All patients with areolar involvement had stage 3 breast cancer and were located centrally in the breast.


We conclude from these data that nipple preservation is not a reasonable option for mastectomy patients. However, preservation of the areola with mastectomy in selected patients warrants further study.

Key Words

Areola preservationSkin-sparing mastectomyNipple involvementBreast reconstruction
Download to read the full article text

Copyright information

© The Society of Surgical Oncology, Inc. 2002