Original Articles

Annals of Surgical Oncology

, Volume 9, Issue 2, pp 165-168

First online:

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

  • Rache M. SimmonsAffiliated withDepartment of Surgery, Weill Medical College of Cornell UniversityThe New York Presbyterian Hospital Email author 
  • , Meghan BrennanAffiliated withStrang Weill Cornell Breast Center
  • , Paul ChristosAffiliated withDepartment of Public Health, Weill Medical College of Cornell University
  • , Valencia KingAffiliated withWeill Medical College of Cornell University
  • , Michael OsborneAffiliated withDepartment of Surgery, Weill Medical College of Cornell UniversityThe New York Presbyterian Hospital

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access



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 preservation Skin-sparing mastectomy Nipple involvement Breast reconstruction