Anatomical Approach for the Evaluation of the Nipple-Areolar Complex

The nipple-areolar complex (NAC) is an anatomically unique region from which several normal variants and pathologies arise. Understanding its anatomy is crucial for accurate clinical and imaging assessments, aiding with differential diagnosis, and ensuring radiologic-pathologic concordance. Mammography and US are commonly used for NAC evaluation; however, these are susceptible to technical limitations such as tissue superimposition and artifacts, compromising visualization of abnormalities in this area. Although MRI offers higher sensitivity, it is not the initial evaluation modality. A comprehensive clinical inspection is necessary because it may reveal abnormalities not apparent on imaging. This article offers an anatomical approach to the NAC evaluation, simplifying differential diagnoses by reviewing imaging techniques and clinical features of common NAC abnormalities.