Breast cancer surgery has greatly changed over the past decades; nowadays skin-sparing mastectomy (SSM) and immediate reconstruction is considered a valid oncological option to achieve good aesthetic results. The success of SSM led to several studies aimed to investigate NAC involvement whose removal increases the patient's sense of mutilation. In this study the Authors investigate the incidence of recurrences in nipple sparing mastectomy (NSM) comparing it with the other techniques to assess the actual risk of tumor involvement of the NAC; besides, they analyse the patients' satisfaction and the NSM impact on quality of life through the utilization of a questionnaire. Clinical complications, aesthetic as well as oncological and psychological results have been analysed. They conclude that in selected cases NSM can be performed without additional risks because the incidence of recurrence after NSM is similar to that of radical mastectomy. Moreover, the aesthetic and psychological outcome are considered positive by the patients.