Background: The nipple-areolar complex (NAC) is an important breast structure that can vary in appearance clinically and with breast imaging. Mammography, ultrasound, and breast magnetic resonance imaging (MRI) are all utilized in the work up of pathologic conditions of the NAC. Appropriate positioning and imaging are key, including placing the nipple in profile on the mammogram to identify a potential retroareolar mass and utilizing a standoff pad with sonography. Both benign and malignant etiologies impact the NAC. Benign etiologies include skin conditions such as eczema and psoriasis of the nipple, adenoma, papilloma, leiomyoma, duct ectasia, periductal mastitis, and abscess. Approximately 8% of carcinomas occur in the subareolar location. Malignancies of the NAC include Paget disease, ductal carcinoma in situ, and invasive carcinomas.
Learning Objectives: 1. Summarize the intricate anatomy of the nipple-areolar complex (NAC), including variations in appearance. 2. Explore the spectrum of benign and malignant pathologies of the NAC, including the clinical presentations, imaging features, and pathology slides. 3. Review appropriate imaging techniques with mammography, ultrasound, and breast MRI. 4. Discuss current management recommendations for NAC pathology.
Abstract Content/Results: This educational exhibit is a pictorial review of the various benign and malignant etiologies of the breast. Key features include discussion of normal anatomy and variants, appropriate positioning and imaging in the breast department, tissue diagnosis with image guided biopsy, review of pathology slides, and discussion of the management and treatment plan for each etiology. 10-15 cases will be shown to demonstrate the various benign and malignant pathologies.
Conclusion: There are a variety of conditions that can affect the nipple-areolar complex. Benign etiologies include skin conditions such as eczema, intraductal papillomas, infections, and inflammatory processes. Malignancies such as Paget disease, ductal carcinoma in situ, and invasive carcinomas must be considered with suspicious clinical and imaging findings. Appropriate positioning and imaging are key for the diagnosis and treatment of these various conditions.