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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Evaluating acute nipple inversion, imaging findings and outcomes
Kyle M Hatcher1, Amie Leon1, Lauren F Cornell2
1Mayo Clinic Florida, Department of Radiology, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
Clinical Imaging
|August 1, 2024
Summary
New nipple inversion can be concerning, but diagnostic mammography and ultrasound are reliable tools for detecting malignancy. Breast MRI is typically reserved for cases with suspicious symptoms or clinical findings.
Area of Science:
- Radiology
- Breast Imaging
- Oncology
Background:
- Acute nipple inversion is a concerning symptom for patients.
- It can be associated with breast malignancy, posing diagnostic challenges.
- Current management guidelines lack consensus.
Purpose of the Study:
- To review institutional experience with new nipple inversion.
- To analyze malignant associations, imaging utilization, and patient outcomes.
- To improve the management of acute nipple inversion.
Main Methods:
- Retrospective review of breast imaging reports (1/2010-6/2022).
- Included patients with new nipple inversion.
- Collected retroareolar imaging findings, BI-RADS assessments, pathology, and follow-up data.
Main Results:
- 414 patients with new nipple inversion were identified.
- 6.5% of cases (27/414) were associated with malignant lesions.
- Diagnostic mammography/ultrasound demonstrated high sensitivity (92.6%) and NPV (99.3%) for malignancy.
Conclusions:
- Diagnostic mammography/ultrasound is reliable for evaluating acute nipple inversion.
- These modalities show high sensitivity and NPV for excluding malignancy.
- Breast MRI and surgical referral should be reserved for suspicious clinical findings.
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