1
|
Luigi B, Carlo V, Corrado C, Orlando C. The nipple-areolar complex: anatomy, methods and pathologic findings, between senologist and dermatologist. J Ultrasound 2023; 26:239-247. [PMID: 36085438 PMCID: PMC10063719 DOI: 10.1007/s40477-022-00722-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/22/2022] [Indexed: 10/14/2022] Open
Abstract
The purpose of this presentation is to show the ultrasonography findings of normal variants and benign and malignant diseases that affect the nipple-areolar complex. Many of which have unspecific clinical and radiological presentations that can present a challenge for medical specialists. Experienced specialists need to know the different imaging modalities used to study the nipple-areolar complex and the aspect not exactly senology, as well as dermatologist who approach the ultrasound must know the anatomy of this complex area. We will show you a combined clinical and radiological approach to evaluate the nipple-areolar complex, the findings for the normal morphology and the most common benign and malignant diseases that can affect this region. We discuss the characteristics of the different ultrasonography findings and provide guidance on how to avoid artifacts and pitfalls.
Collapse
Affiliation(s)
- Basile Luigi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, via Pansini 5, 80138, Naples, Italy.
| | - Varelli Carlo
- Radiology Unit, Istituto Diagnostico Varelli, Naples, Italy
| | | | | |
Collapse
|
2
|
Geffroy D. La peau des seins, première frontière anatomique. IMAGERIE DE LA FEMME 2020. [DOI: 10.1016/j.femme.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
3
|
Chiorean A, Pintican RM, Szep M, Feier D, Rogojan L, Fetica B, Dindelegan G, Vlad B, Duma M. Nipple Ultrasound: A Pictorial Essay. Korean J Radiol 2020; 21:955-966. [PMID: 32677380 PMCID: PMC7369201 DOI: 10.3348/kjr.2019.0831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 11/15/2022] Open
Abstract
Ultrasound (US) is an attractive diagnostic approach to identify both common and uncommon nipple pathologies, such as duct ectasia, nipple abscess, nipple leiomyoma, nipple adenoma, fibroepithelial polyp, ductal carcinoma in situ (restricted to nipple), invasive carcinoma, and Paget's disease. US is the reliable first-line imaging technique to assess nipple pathologies. It is useful to identify and characterize nipple lesions. Additionally, we have presented the mammography and MRI outcomes correlated with histopathologic features for the relevant cases.
Collapse
Affiliation(s)
- Angelica Chiorean
- Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Medimages Breast Center, Cluj-Napoca, Romania
| | - Roxana Maria Pintican
- Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Radiology and Medical Imaging, County Clinical Emergency Hospital, Cluj-Napoca, Romania.
| | - Madalina Szep
- Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Medimages Breast Center, Cluj-Napoca, Romania
| | - Diana Feier
- Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Medimages Breast Center, Cluj-Napoca, Romania
| | - Liliana Rogojan
- Department of Pathology, County Clinical Emergency Hospital, Cluj-Napoca, Romania
| | - Bogdan Fetica
- Department of Pathology, County Clinical Emergency Hospital, Cluj-Napoca, Romania.,Department of Pathology, Ion Chiricuţă, Oncology Institute, Cluj-Napoca, Romania
| | - George Dindelegan
- Department of Surgery, County Clinical Emergency Hospital, Cluj-Napoca, Romania
| | - Bura Vlad
- Department of Radiology and Medical Imaging, County Clinical Emergency Hospital, Cluj-Napoca, Romania
| | - Magdalena Duma
- Department of Radiology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Medimages Breast Center, Cluj-Napoca, Romania.,Department of Radiology, Micromedica Clinic, Piatra Neamt, Romania
| |
Collapse
|
4
|
Maladie de Paget du mamelon. IMAGERIE DE LA FEMME 2020. [DOI: 10.1016/j.femme.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
5
|
Kekade S, Gochhait D, Srinivas BH, Siddaraju N. Scrape cytology of nipple ulceration in a male breast: A rare entity with many differential diagnoses. Cytopathology 2019; 30:552-554. [PMID: 30873679 DOI: 10.1111/cyt.12691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Shailesh Kekade
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Debasis Gochhait
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Neelaiah Siddaraju
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
6
|
Maladie de Paget du mamelon. IMAGERIE DE LA FEMME 2016. [DOI: 10.1016/j.femme.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Boulanger L, Demetz J. [How to explore breast skin lesion?: Guidelines]. ACTA ACUST UNITED AC 2015; 44:921-6. [PMID: 26527029 DOI: 10.1016/j.jgyn.2015.09.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 09/18/2015] [Indexed: 11/30/2022]
Abstract
A change in the shape or appearance of the nipple-areola complex, especially if it is unilateral and recent appearance, is a sign of underlying breast tumor. Breast imaging is then required (grade C). Any erythematous lesion of the nipple or nipple-areola can be a Paget's disease, an adenoma of the nipple or a nipple eczema. Clinical course and pattern can point to a diagnosis without sufficient specificity (LE4). If nipple eczema is suspected, it is recommended to perform a test treatment with topical corticosteroids. In case of failure or if a Paget's disease of the breast is suspected, a biopsy must be done. When indicated, it is not possible to recommend a biopsy modality (scrape cytology, punch biopsy, nipple core biopsy and surgical excision) compared to another. When imaging exploration of the nipple-areola complex is necessary, ultrasound and mammography are recommended as first-line. In the absence of signal, an MRI is recommended as second-line (grade C).
Collapse
Affiliation(s)
- L Boulanger
- Service de chirurgie gynécologique, cancérologie gynécologique et mammaire, clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
| | - J Demetz
- Service de chirurgie gynécologique, cancérologie gynécologique et mammaire, clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| |
Collapse
|
8
|
Geffroy D, Doutriaux-Dumoulins I. Clinical abnormalities of the nipple-areola complex: The role of imaging. Diagn Interv Imaging 2015; 96:1033-44. [PMID: 26385836 DOI: 10.1016/j.diii.2015.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/05/2015] [Indexed: 11/17/2022]
Abstract
Clinical examination of the nipple is part of normal breast screening procedures. Abnormal processes of benign or malignant nature may be reflected by erythema, erosion, swelling or acquired inversion. In patients presenting with a persistent unilateral nipple lesion, it is advisable to collect a sample to exclude Paget's disease of the nipple, a rare form of ductal carcinoma in situ (DCIS). Imaging should be performed to detect breast cancer, which is found in more than 80% of cases, and determine its possible multifocal nature. Breast MRI is indicated if breast-conserving surgery is planned. The main differential diagnoses are erosive adenomatosis and eczema of the nipple. Acquired inverted nipple is generally of inflammatory origin. It is usually diagnosed by conventional breast examination but breast MRI can be helpful when in doubt about possible underlying neoplasia.
Collapse
Affiliation(s)
- D Geffroy
- Imagerie médicale, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard J.-Monod, 44805 Nantes Saint-Herblain cedex, France.
| | - I Doutriaux-Dumoulins
- Imagerie médicale, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard J.-Monod, 44805 Nantes Saint-Herblain cedex, France
| |
Collapse
|