Retroareolar breast carcinoma: clinical, imaging, and histopathologic features

Abstract

Purpose: To evaluate the clinical, imaging, and histopathologic features of breast carcinoma in the retroareolar tissues and to determine whether there are any characteristics common to this location.

Materials and methods: Thirty-five patients (age range, 38-77 years) with 37 retroareolar carcinomas were identified retrospectively. Retroareolar carcinoma was defined as that within 2 cm of the nipple-areolar complex. Mammographically occult tumors were identified by using histopathologic records (n = 4) or clinical examination findings (n = 6).

Results: Twenty-nine (78%) tumors had clinical findings, including palpable mass (n = 29), associated nipple inversion or retraction (n = 4), and associated nipple discharge (n = 2). Twenty-seven (73%) tumors had mammographic findings of mass (n = 16), mass with calcifications (n = 5), and microcalcifications (n = 6; four of these microcalcifications were associated with a mammographically occult palpable mass). Ultrasound was performed in 17 tumors, all of which were hypoechoic. The stage of 31 carcinomas was known: one was stage 0, 17 were stage I, and 13 were stage II. Histopathologic analysis revealed 35 ductal carcinomas and two invasive lobular carcinomas.

Conclusion: Retroareolar carcinoma usually manifests as a palpable mass. Mammography is less sensitive in this area than in other areas of the breast. Ultrasound can be a valuable adjunct in the assessment of retroareolar malignancy.