To the Editor.—Several things disturb me about Dr Rose's report of carcinoma in a transplanted nipple (Archives 1980;115:1131-1132).
First, Dr Rose stated that nothing serves as well for nipple reconstruction as the original nipple. This is absolutely not true since, in transferring the nipple twice, it becomes scarred and depigmented, often losing its original appearance. This is borne out by the photograph in Dr Rose's article.
Second, Dr Rose asserts that, at the time of the original mastectomy, the nipple is often transplanted to the skin of the thigh, where it is later available for reconstruction. In my experience, it is not often transplanted, and when it is, the thigh is not the best place since the resultant scar may be quite noticeable.
Third, the nipple should not have been transplanted in this case since the tumor was too large and the lymph nodes were involved. The patient should