Multimodality approach to the nipple-areolar complex: a pictorial review and diagnostic algorithm

Abstract

The anatomic and histologic characteristics of the nipple-areolar complex make this breast region special. The nipple-areolar complex can be affected by abnormal development and a wide spectrum of pathological conditions, many of which have unspecific clinical and radiological presentations that can present a challenge for radiologists. The nipple-areolar complex requires a specific imaging workup in which a multimodal approach is essential. Radiologists need to know the different imaging modalities used to study the nipple-areolar complex, as well as their advantages and limitations. It is essential to get acquainted with the acquisition technique for each modality and the spectrum of findings for the different conditions. This review describes and illustrates a combined clinical and radiological approach to evaluate the nipple-areolar complex, emphasizing the findings for the normal morphology, developmental abnormalities, and the most common benign and malignant diseases that can affect this region. We also present a diagnostic algorithm that enables a rapid, practical approach to diagnosing condition involving the nipple-areolar complex.

Is the skin microbiota a modifiable risk factor for breast disease?: A systematic review

“…The anatomy of the nipple-areolar J o u r n a l P r e -p r o o f complex is unique: a multi cell-layered structure containing numerous nerve endings, sebaceous and apocrine sweat glands. 16 Skin dysbiosis has been established with breast skin conditions (psoriasis and atopic dermatitis), 14 and skin morphological changes are seen with underlying BD (erythema, dimpling, oedema and peau d'orange). 17 Skin dysbiosis has also been linked with skin cancer through the induction of chronic self-maintaining inflammation.…”

“…Herein, the ‘breast skin’ is our primary focus. The anatomy of the nipple-areolar complex is unique: a multi cell-layered structure containing numerous nerve endings, sebaceous and apocrine sweat glands [ 16 ]. Skin dysbiosis has been established with breast skin conditions (psoriasis and atopic dermatitis) [ 14 ], and skin morphological changes are seen with underlying BD (erythema, dimpling, oedema and peau d'orange) [ 17 ].…”

Diseases and abnormalities of the nipple-areolar complex: a case report series

“…Сосково-ареолярный комплекс представляет собой пигментированную область в наиболее выступающей части молочной железы, в которой сходятся млечные протоки, дренирующие 15-20 долей молочной железы [7]. Эта область молочной железы из-за её анатомической сложности [8], поверхностного расположения и подвижности требует особого внимания при клиническом осмотре и инструментальной визуализации.…”

Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions: a necessary test or an obsolete skill?

“…The use and benefit of alternative imaging modalities such as breast MRI to further evaluate suspicious clinical findings with normal mammography and breast ultrasound was not explored in our study. Breast MRI is particularly useful in the assessment of focal suspicious palpable areas of concern [ 8 ].…”