Nipple-Areola Complex (NAC) Irradiation After Nipple-Sparing Mastectomy and Reconstruction

Inclusion Criteria: * Patients must have histologically confirmed in-situ or invasive breast carcinoma. * Tis, T1, T2 invasive or non-invasive carcinoma of the breast; lesion less than 4 cm. * Unifocal, multifocal or multicentric breast cancers that can be removed by nipple sparing mastectomy with negative surgical margins. * No extensive intraductal component or patient with distant metastases. * Patients must be \> 18 years of age. * No concomitant or history of nipple discharge or skin involvement. * No prior history of malignancy (less than 5 years prior to study entry), except non-melanomatous skin cancer. * No prior history of radiation to the chest. * No collagenous disease (systemic lupus erythematosis, scleroderma, dermatomyositis)No previous non-hormonal therapy including radiation or chemotherapy for current breast cancer. * No patients with Paget's disease of the nipple. * No patients with co-existing medical conditions with life expectancy \< 2 years. * No pregnant or lactating women. * Eastern Cooperative Oncology Group (ECOG) 0 - 2. * Signed study-specific informed consent form prior to the study entry. Exclusion Criteria: * Retroareolar breast cancer lesions within one cm, depth from the skin surface. * Concomitant or history of nipple discharge or skin involvement. * Patient with distant metastases. * Patient with extensive intraductal carcinoma. * Any previously irradiated ipsilateral breast cancer. * Patients with Paget's disease of the nipple. * Patient…