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

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Abstract

The nipple–areolar complex is a specific anatomical and histological structure. Normal structure and pathological process variabilities and the complexity of diagnostic imaging cause difficulties for radiologists and physicians. Breast magnetic resonance imaging is highly sensitive for structural features and nipple-areolar complex cancer detection. Magnetic resonance imaging is a useful diagnostic tool when mammography and ultrasound findings are inconclusive. It allows visualization of the retroareolar region, suitable for the diagnosis of papillomas, adenomas, Paget’s disease, ductal carcinoma in situ, and invasive ductal carcinoma.

This is a case report on identifying the pathology and anomalies of the nipple-areolar complex, which may benefit radiologists, gynecologists, and residents.

About the authors

Elena N. Karanadze

Clinical Diagnostic Center MEDSI on Krasnaya Presnya

Author for correspondence.
Email: ekaranadze@mail.ru
ORCID iD: 0000-0001-6745-1672

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Valentin E. Sinitsyn

Lomonosov Moscow State University, Medical Scientific and Educational Center

Email: info@npcmr.ru
ORCID iD: 0000-0002-5649-2193
SPIN-code: 8449-6590

MD, Dr. Sci. (Med), Professor

Russian Federation, Moscow

Mariia A. Karanadze

The Russian National Research Medical University named after N.I. Pirogov

Email: ekaranadze@mail.ru
ORCID iD: 0009-0008-1723-6796
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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2. Figure 1. Erosive nipple changes in Paget’s disease.

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3. Figure 2. Paget’s disease: increased blood flow on color Doppler imaging.

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4. Figure 3. Magnetic resonance imaging of Paget’s disease (early enhancement phase): the retroareolar area of segmental enhancement from the nipple level to the posterior breast (arrow).

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5. Figure 4. Magnetic resonance imaging of Paget’s disease (maximum intensity projection): the retroareolar area of segmental enhancement from the nipple level to the posterior breast (arrow).

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6. Figure 5. A nipple adenoma: mammography (mediolateral oblique projection).

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7. Figure 6. A nipple adenoma: mammography (craniocaudal projection).

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8. Figure 7. Magnetic resonance imaging of a nipple adenoma (early postcontrast series): a right nipple mass homogeneously accumulating a contrast agent (arrow).

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9. Figure 8. Magnetic resonance imaging of a nipple adenoma (parametric map): a right nipple mass with rapid contrast enhancement and subsequent elimination, type III graphic curve.

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10. Figure 9. Magnetic resonance imaging (early postcontrast series): asymmetric contrast accumulation in the left nipple; normal finding (arrow).

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11. Figure 10. Magnetic resonance imaging (MIP): asymmetric contrast accumulation in the left nipple; normal finding (arrow).

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12. Figure 11. Ultrasound image of the left breast with the inverted nipple.

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13. Figure 12. Magnetic resonance imaging (subtraction): a retroareolar mass with accumulation of contrast agent (inverted nipple, arrow).

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