Objective: To assess a new excision technique for sub papillary fragments and the examination of corresponding serial frozen histological sections to predict nipple involvement in breast cancer. Methodology: A total of 158 total mastectomy specimens from patients affected by ductal carcinoma in situ (DCIS) (n = 15) or invasive ductal carcinoma (stages I, II, or IIIA) (n = 143) were examined. To obtain the entire sample area, the terminal sub papillary milk duct bunch was isolated. Fragments approximately 1.5 cm in length were excised and sectioned in parallel at the base of the papilla using a cold bistoury. Three transverse histological sections (4 µm each) at 200 µm intervals that included the entire isolated fragments were subjected to frozen section examination. The sections were stained with hematoxylin-eosin and were evaluated. The remainder of each fragment was embedded in paraffin and 4 µm sections were subsequently stained with hematoxylin-eosin and examined. Results: There were two false-negative (1.3%) and five false-positive (3.1%) findings among the frozen and paraffin sections analyzed. A statistical analysis of the frozen section examinations showed a sensitivity of 92.0%, a specificity of 96.2%, a positive predictive value of 82.1%, a negative predictive value of 98.4%, and an accuracy of 95.4%. Conclusion: The frozen section examination technique described here detected papilla involvement in breast cancer with great accuracy.