Nipple retraction: Pulling in of portion of nipple, asymmetrically, often focally; may or may not involve areola
Nipple inversion: Entire nipple retracted centrally with apex deep to level of breast itself
Paget disease of nipple: Adenocarcinoma (Paget) cells within nipple epidermis; associated with local inflammatory response, pruritus, and excoriation
May cause nipple flattening or even retraction but should be recognized clinically
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Machida Y et al: Preoperative breast MRI: reproducibility and significance of findings relevant to nipple-areolar complex involvement. Breast Cancer. 25(4):456-63, 2018
Mariscotti G et al: Preoperative MRI evaluation of lesion-nipple distance in breast cancer patients: thresholds for predicting occult nipple-areola complex involvement. Clin Radiol. 73(8):735-43, 2018
Hernandez Yenty QM et al: Treatment of the benign inverted nipple: A systematic review and recommendations for future therapy. Breast. 29:82-9, 2016
Piato JR et al: MRI to predict nipple involvement in breast cancer patients. AJR Am J Roentgenol. 206(5):1124-30, 2016
Provencher L et al: Is clinical breast examination important for breast cancer detection? Curr Oncol. 23(4):e332-9, 2016
Geffroy D et al: Clinical abnormalities of the nipple-areola complex: The role of imaging. Diagn Interv Imaging. 96(10):1033-44, 2015
Stone K et al: A Review of Anatomy, Physiology, and Benign Pathology of the Nipple. Ann Surg Oncol. 22(10):3236-40, 2015
Moon JY et al: Malignant invasion of the nipple-areolar complex of the breast: usefulness of breast MRI. AJR Am J Roentgenol. 201(2):448-55, 2013
D'Alonzo M et al: Clinical and radiological predictors of nipple-areola complex involvement in breast cancer patients. Eur J Cancer. 48(15):2311-8, 2012
Sakamoto N et al: Is MRI useful for the prediction of nipple involvement? Breast Cancer. Epub ahead of print, 2012
Lim HS et al: Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation. Radiographics. 31(7):1973-87, 2011
Nicholson BT et al: Nipple-areolar complex: normal anatomy and benign and malignant processes. Radiographics. 29(2):509-23, 2009
Da Costa D et al: Common and unusual diseases of the nipple-areolar complex. Radiographics. 27 Suppl 1():S65-77, 2007
Günhan-Bilgen I et al: Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases. Radiology. 223(3):829-38, 2002
Magro G et al: [Fibromatosis of the breast: a clinical, radiological and pathological study of 6 cases] Pathologica. 94(5):238-46, 2002
Kushwaha AC et al: Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings. AJR Am J Roentgenol. 174(2):535-8, 2000
Burke ET et al: Paget disease of the breast: a pictorial essay. Radiographics. 18(6):1459-64, 1998
Gough DB et al: A 50-year experience of male breast cancer: is outcome changing? Surg Oncol. 2(6):325-33, 1993
Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
Rees BI et al: Nipple retraction in duct ectasia. Br J Surg. 64(8):577-80, 1977
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Synonyms
Flattening or tethering of nipple
Definitions
Nipple retraction: Pulling in of portion of nipple, asymmetrically, often focally; may or may not involve areola
Nipple inversion: Entire nipple retracted centrally with apex deep to level of breast itself
Paget disease of nipple: Adenocarcinoma (Paget) cells within nipple epidermis; associated with local inflammatory response, pruritus, and excoriation
May cause nipple flattening or even retraction but should be recognized clinically
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Machida Y et al: Preoperative breast MRI: reproducibility and significance of findings relevant to nipple-areolar complex involvement. Breast Cancer. 25(4):456-63, 2018
Mariscotti G et al: Preoperative MRI evaluation of lesion-nipple distance in breast cancer patients: thresholds for predicting occult nipple-areola complex involvement. Clin Radiol. 73(8):735-43, 2018
Hernandez Yenty QM et al: Treatment of the benign inverted nipple: A systematic review and recommendations for future therapy. Breast. 29:82-9, 2016
Piato JR et al: MRI to predict nipple involvement in breast cancer patients. AJR Am J Roentgenol. 206(5):1124-30, 2016
Provencher L et al: Is clinical breast examination important for breast cancer detection? Curr Oncol. 23(4):e332-9, 2016
Geffroy D et al: Clinical abnormalities of the nipple-areola complex: The role of imaging. Diagn Interv Imaging. 96(10):1033-44, 2015
Stone K et al: A Review of Anatomy, Physiology, and Benign Pathology of the Nipple. Ann Surg Oncol. 22(10):3236-40, 2015
Moon JY et al: Malignant invasion of the nipple-areolar complex of the breast: usefulness of breast MRI. AJR Am J Roentgenol. 201(2):448-55, 2013
D'Alonzo M et al: Clinical and radiological predictors of nipple-areola complex involvement in breast cancer patients. Eur J Cancer. 48(15):2311-8, 2012
Sakamoto N et al: Is MRI useful for the prediction of nipple involvement? Breast Cancer. Epub ahead of print, 2012
Lim HS et al: Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation. Radiographics. 31(7):1973-87, 2011
Nicholson BT et al: Nipple-areolar complex: normal anatomy and benign and malignant processes. Radiographics. 29(2):509-23, 2009
Da Costa D et al: Common and unusual diseases of the nipple-areolar complex. Radiographics. 27 Suppl 1():S65-77, 2007
Günhan-Bilgen I et al: Inflammatory breast carcinoma: mammographic, ultrasonographic, clinical, and pathologic findings in 142 cases. Radiology. 223(3):829-38, 2002
Magro G et al: [Fibromatosis of the breast: a clinical, radiological and pathological study of 6 cases] Pathologica. 94(5):238-46, 2002
Kushwaha AC et al: Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings. AJR Am J Roentgenol. 174(2):535-8, 2000
Burke ET et al: Paget disease of the breast: a pictorial essay. Radiographics. 18(6):1459-64, 1998
Gough DB et al: A 50-year experience of male breast cancer: is outcome changing? Surg Oncol. 2(6):325-33, 1993
Le Gal M et al: Mammographic features of 455 invasive lobular carcinomas. Radiology. 185(3):705-8, 1992
Rees BI et al: Nipple retraction in duct ectasia. Br J Surg. 64(8):577-80, 1977
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