Skin-sparing mastectomy (SSM) usually includes the areolar-nipple complex with only a small area of skin (A). The exposed breast tissue represents the superficial specimen margin. Sixty-four of 168 (38%) SSMs had a positive superficial specimen margin, with carcinoma either within 1 mm of (B, ×100) or at (C, ×100) the inked margin. Thirteen of 64 (20%) SSMs with a positive superficial specimen margin had residual carcinoma in the additional superficial margin (ASM), a few as invasive carcinoma (D, ×100) but most as DCIS (E, ×40). Fifty-three percent of ASMs contained benign breast epithelium (F, ×40).