Nipple-areola complex-sparing mastectomy (NSM) is a surgical procedure that allows the preservation of the skin and nipple-areola complex (NAC) in mastectomy. The use of NSM for breast cancer is still controversial. The appropriate standard for selecting patients with low risk of NAC involvement has not been well established. The clinicopathologicity characteristics of primary tumor (e.g.

tumor-to-nipple distance

tumor location

tumor size

multicentricity

lymph node metastasis

lymphovascular invasion

grade

HER-2 status) have been reported to be associated with NAC involvement. Clinical evaluation of NAC

retroareolar tissue biopsy and evaluation of clinicopathologic characteristics of primary tumor are helpful to patient selection in current clinical practice of NSM. Further studies are still needed to establish uniform selection criteria for NSM in breast cancer patients.