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Nipple-areolar complex: normal anatomy and benign and malignant processes
Radiographics, 04/01/09

Nicholson BT et al. - In a review of normal anatomy and benign and malignant processes of the nipple-areolar complex, it was concluded that radiologists should be aware of the best methods for evaluating each of these entities.

Methods

The nipple-areolar complex may be affected by many normal variations in embryologic development and breast maturation as well as by abnormal processes of a benign or malignant nature.
Benign processes that may affect the nipple-areolar complex include eczema, duct ectasia, periductal mastitis, adenomas, papillomas, leiomyomas, and abscesses; malignant processes include Paget disease, lymphoma, and invasive and noninvasive breast cancers.

Results

Many disorders of the nipple-areolar complex are unique or differ in important ways from those that occur elsewhere in the breast, and they require a diagnostically specific imaging evaluation.
Pts may present with benign developmental variations; inversion, retraction, or enlargement of the nipple, which may have either a benign or a malignant cause; a palpable mass; nipple discharge; skin changes in and around the nipple; infection with resultant nipple changes or a subareolar mass; or abnormal findings at routine mammographic screening.
Further diagnostic imaging may include repeat mammography, breast ultrasonography, galactography, and magnetic resonance imaging.
When skin changes are present, clinical evaluation by the pt’s primary care physician, dermatologist, or surgeon should be part of the diagnostic work-up.

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