Objective: To investigate the safety and feasibility of the nipple complex (NAC) sparing modified mastectomy with first-stage breast reconstruction in treatment of early breast cancer. Methods: During 2010 to 2014, 170 breast cancer patients, according to their own choice, received NAC sparing modified mastectomy with first-stage breast reconstruction (observational group, 102 cases), or modified subcutaneous mastectomy with NAC removal (control group, 68 cases), respectively. The relevant postoperative parameters and postoperative patient’s satisfaction with breast reconstruction and quality of life as well as the incidence of adverse events, recurrence and metastasis during follow-up of the two groups were compared. Results: The duration and volume of wound drainage showed no significant difference between the two groups (both P<0.05); the postoperative patient satisfaction rate (97.06% vs. 51.47%), overall FACT score (150.89±25.34) vs. (100.24±18.47) and high satisfaction rate (83.33% vs. 51.47%) in observational group were significantly higher than those in control group (all P<0.05); there was no significant difference in incidence of adverse events, local recurrence and distant metastasis between the two groups (all P>0.05). Conclusion: NAC sparing modified mastectomy with first-stage breast reconstruction is safe and feasible for early breast cancer, and it is evidently superior to modified subcutaneous mastectomy without NAC preservation with regard to postoperative cosmetic results and improving patient’s quality of life.