BACKGROUND: The last several decades have witnessed significant advances in the surgical management of carcinoma breast. Many have embraced breast conservation as the procedure of choice in carefully selected patients. It provides excellent cosmetic results side by side being oncologically safe. Recent evidences have shown that involvement of nipple areola complex in breast cancer have been over estimated in the past based on older concept of occult tumor in the region of nipple and areola. Preservation of nipple and areola improves the quality of life and reduces the feeling of mutilation and thus is a logical step in conservative management of breast carcinoma. AIMS: (a) To investigate the actual involvement of nipple areola complex clinically and histopathologically. (b) To determine the associated risk factors like site, size, distance, grading and lymph node status. MATERIALS AND METHODS: This was a prospective study over a period of 2008-2011 carried out at Department of General Surgery of a tertiary care centre. Total number of patients included in the study was 54. All patients included in the study had undergone mastectomy for carcinoma of breast (excluding those patients who had clinical involvement of nipple areola complex). RESULTS: Among the patients of the study group majority of breast cancer occurred in age group 41-60 years (42.6%) while incidence of nipple areola involvement was highest in age group 20-40 years. Majority of the patients detected with breast cancer were in stage II (44.4%) while incidence of nipple areola involvement was highest in stage IV in our study. Mean largest dimension of the tumor was between 2-5cms while nipple areola involvement was found to be highest when the tumor is >5cms in largest dimension. Among the cases mean nipple tumor margin distance was between 0-4cms while nipple areola involvement was found to be highest when the nipple tumor margin distance was < 2cms. CONCLUSION: It can be concluded that nipple areola complex sparing mastectomy is an attractive and safe procedure for early breast cancer

BACKGROUND: Pre-operative Chest X-ray (CXR) is routinely ordered locally for patients above a certain age. This study examines the usefulness of such a practice and its clinical impact. METHODS: Prospective audit of 600 consecutive elective surgical patients over a one-year period, assessing the proportion and impact of abnormal CXR findings. RESULTS: The proportion of patients with abnormal CXR increased with worsening ASA status. There was little impact of routine pre-operative CXR on anaesthetic management. Only 10/590 CXR affected anaesthetic technique or choice of therapeutic procedure. CONCLUSION: Targeted investigations should be performed as indicated by clinical findings rather than on the basis of arbitrary age cut offs.