Introduction: Many articles have been published on the safety of skin sparing mastectomy (SSM). Success 
with skin sparing mastectomy has led to the reconsideration of the necessity to remove the skin overlying 
the nipple-areola complex. Leaving this area will improve the cosmetic appearance of the reconstructed 
breast which is the optimal aim of skin sparing mastectomy. The aim of this study is to prove whether or not 
the Nipple Areola Skin Sparing Mastectomy is oncologically safe in Egyptian females. 
Methods: This study included 64 cases of operable breast cancer that underwent modified radical 
mastectomy in the period between January 2010 and December 2010. The excluding criteria were patients 
who have received chemotherapy and patients who had skin changes involving nipple areola complex. All 
specimens were subjected to histopathological examination of the subareolar tissue examination searching 
for malignancy in the subareolar tissue. Patients' demographics, tumor and histological characteristics were 
analyzed & correlated with pathological results.
Results: In 12 cases (18.8 %), the subareolar tissue was positive for malignancy. Positive predictive value 
was tumor size >4 cm, distance between tumor and nipple <6 cm (ρ = 0.05).
Conclusion: Nipple areola skin sparing mastectomy appears to be oncologically safe providing that the 
tumor is small and not close to the nipple and the areola.