Nipple skin removal no longer mandatory in all mastectomies – The nipple areola complex, because it contains terminal ducts, has traditionally been removed as part of every mastectomy procedure for breast cancer. A recently published study from Dr. V Suzanne Klimberg et al of 508 procedures in 293 selected patients compared skin sparing mastectomy with and without preservation of nipple areola skin. Comparable complication rates and local-regional tumor recurrence rates were demonstrated between the two groups. Women who had their nipple areola preserved, not surprisingly, were more pleased with the outcome. Although not all breast cancer patients are eligible, for those with stage I and II breast cancer and for those downstaged with chemotherapy, the nipple skin sparing mastectomy appears safe, and offers a superior cosmetic result with the possibility of one stage immediate breast reconstruction.