Nipple sparing mastectomy is a technique used for complete removal of the tumor and breast tissue without removal of the skin, nipple and areola. The incision is made around the areola or underneath the breast and the entire breast is removed through this incision. The cancer must not involve the nipple or tissue immediately underneath the nipple for this operation to performed safely. At the time of the mastectomy, a small biopsy of the tissue under the nipple is performed and sent intra-operatively to the pathologist. If the biopsy contains cancer, the nipple and the areola are removed at the time of the mastectomy.