This work is licensed under the Creative commons Attribution 4.0 License. Published by Pacifc Group of e-Journals (PaGe) Original Article Importance of Extensive Sampling Methodology on the Pick up Rate of Involvement of Nipple Areola in Carcinoma Breast DOI: 10.21276/AWCH.1512 Introduction Breast cancer is the most common cancer in women both in the developed and the developing world. The incidence of carcinoma breast is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles 1 Carcinoma breast is the most common cancer in women worldwide. Nearly 1.7 million new cases were diagnosed in 2012 (second most common cancer overall). This represents about 12% of all new cancer cases and 25% of all cancers in women. 2 Many studies have been done to know the incidence rate of involvement of nipple areola in cases of carcinoma breast with percentage involvement according to the studies ranging from 0% to 58% 3-6 . In all the studies yielding a higher percentage of involvement, multiple sections were taken instead of traditional one vertical section 4,6 . Grossing methodology used can infuence the pick up rate of carcinoma involvement in nipple areolar region in cases of carcinoma breast. Nipple areola involvement can be due to direct extension of primary tumour, dissemination by way of ducts or malignant changes independent of primary tumour 7 . Pathologically mechanism of spread can be of 3 types- direct extension, dissemination through ducts and lymphatics 8 . Routinely during grossing of mastectomy specimens, one vertical section is taken from the nipple areolar region and submitted. In cases where there is gross involvement of nipple and areola the entire nipple areolar region is submitted by taking multiple sections 9,10 In our study even while nipple and areolar region was grossly uninvolved we took multiple sections and extensive sampling methodology was followed. Hence we followed extensive sampling technique, as the traditional one sagittal section is likely to underestimate NAC involvement. Aim of the study was to compare the pick up rate of involvement of nipple areola complex in carcinoma breast cases by extensive nipple areolar sampling vs routine methodology. Materials and Methods A prospective study was done on a total of 30 mastectomy specimens between 2011 and 2013. The study was carried out in Department of Pathology, Vardhman Mahavir Sumanashree Mallappa*, Arti Khatri, Nimisha Sharma and Uma Sharma Department of Pathology, VMMC & Safdarjung Hospital, New Delhi, India ABSTRACT Background: Breast cancer is the leading cause of death from cancer for females 40-44 years of age which is responsible for 19% of cancer related death in women. The exact percentage of NAC involvement in breast carcinoma cases depends on many parameters. Grossing methodology used can infuence the pick up rate of carcinoma involvement in nipple areolar region in cases of carcinoma breast. Methods: Aim of the study was to compare the pick up rate of involvement of nipple areola complex in carcinoma breast cases by extensive nipple areolar sampling vs routine methodology. We studied 30 cases of breast carcinomas using extensive sampling methodology and compared the results with routine sectioning method. All the cases were having grossly uninvolved nipple areolar complex. Chisquare test was used to know if there was an association between the grossing technique and positivity rate of nipple areolar complex. Chi-square table was prepared and statistics was calculated using SPSS software. Result: There was a statistically signifcant association between the grossing methodology and pick up rate of nipple areolar involvement in carcinoma breast. Conclusion: Our fndings showed that, if Only gross involvement of nipple is taken into consideration large amount of occult NAC involvement will be missed out, which can be picked up only by extensive sampling of NAC. Increase in the accuracy of involvement of nipple areolar complex can further guide in the treatment of breast carcinoma cases by nipple sparing mastectomy. Keywords: Breast Carcinoma, Grossing Technique, Occult Lesion, Nipple Sparing Mastectomy, Comparison Of Methods