Abstract

The Nipple-Areolar Complex (NAC) is a highly specialized region of the anterior chest wall and breast. Studying the nipple-areolar complex (NAC) in the cadaver provides a multi-layered understanding from superficial skin morphology and ductal anatomy to the intricate, life-preserving neurovascular pedicles all of which reveal its fundamental and unique morphology. The complexity of the ductal as well as muscular arrangements within the nipple-areolar complex makes it a sensitive tissue superimposed with hormonal fluctuations. Hence this review focuses on the structural and functional aspects of the human nipple-areolar complex with a special emphasis on its surgical and anatomical significance.

• 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 Mar; 26(1): 239-247. doi: 10.1007/s40477-022- 00722-y. Epub 2022 Sep 9. PMID: 36085438; PMCID: PMC10063719.
• 2.   Nicholson B.T., Harvey J.A., Cohen M.A. Nipple-areolar complex: normal anatomy and benign and malignant processes. Radiographics. 2009 Mar-Apr;29(2):509-23. doi: 10.1148/rg.292085128. PMID: 19325062.
• 3.   Love S.M., Barsky S.H.. Anatomy of the nipple and breast ducts revisited. Cancer. 2004 Nov 1; 101(9): 1947-57. doi: 10.1002/cncr.20559. PMID: 15382093.
• 4.   Altuntaş Z.K., Kamburoğlu H.O., Yavuz N., Dadacı M., İnce B. Long-term changes in nippleareolar complex position and inferior pole length in superomedial pedicle inverted ‘t’ scar reduction mammaplasty. Aesthetic Plast Surg. S. Surraj, K. Emmanuel. The Purpose and Utility of the Nipple-Areolar Complex of the Mammary Gland with a Special Emphasis on its Anatomical Significance: A Review.106 Indian Journal of Anatomy Indian Journal of Anatomy/Volume 14, Number 3/September – December 2025 2015 Jun; 39(3): 325-30. doi: 10.1007/s00266-015- 0470-3. Epub 2015 Mar 18. PMID: 25784103.
• 5.   Lyons D., Wahab R.A., Vijapura C., Mahoney M.C. The nipple-areolar complex: comprehensive imaging review. Clin Radiol. 2021 Mar; 76(3): 172-184. doi: 10.1016/j. crad.2020.09.013. Epub 2020 Oct 17. PMID: 33077158.
• 6.   Da Costa D., Taddese A., Cure M.L., Gerson D., Poppiti R. Jr, Esserman L.E. Common and unusual diseases of the nipple-areolar complex. Radiographics. 2007 Oct; 27 Suppl 1: S65-77. doi: 10.1148/rg.27si075512. PMID: 18180236.
• 7.   Del Riego J., Pitarch M., Codina C., Nebot L., Andreu F.J., Aparicio O., Medina A, Martín A. Multimodality approach to the nipple-areolar complex: A pictorial review and diagnostic algorithm. Insights Imaging. 2020 Aug 5; 11(1): 89. doi: 10.1186/s13244-020-00896-1. PMID: 32757082; PMCID: PMC7406635.
• 8.   Wei Y., Zhu Q., Li J., Jiang Y. Clinical and Sonographic Features of Mammary Paget’s Disease. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Jun 20; 39(3): 396-400. doi: 10.3881/j. issn.1000-503X.2017.03.016. PMID: 28695812.
• 9.   An H.Y., Kim K.S., Yu I.K., Kim K.W., Kim HH. Image presentation. The nipple-areolar complex: a pictorial review of common and uncommon conditions. J Ultrasound Med. 2010 Jun; 29(6): 949-62. doi: 10.7863/ jum.2010.29.6.949. PMID: 20498469.
• 10.   Pitarch M., Alcatraz R., Comerma L., Vázquez de Las Heras I., Azcona J., Wiedemann A., Prutki M., Fallenberg E.M. An update on multimodal imaging strategies for nipple discharge: from detection to decision. Insights Imaging. 2025 Mar 24; 16(1): 70. doi: 10.1186/ s13244-025-01947-1. PMID: 40126685; PMCID: PMC11933581.
• 11.   Li J., Diao Y., Chen R., Chen J., Pei X. Rare Presentation and Diagnostic Challenges of Intraductal Papilloma in an Adolescent: A Case Report. Cureus. 2025 Jun 12; 17(6): e85881. doi: 10.7759/cureus.85881. PMID: 40656309; PMCID: PMC12255849.
• 12.   Huang J., He N., Li J., Chen J., Guan C., Wu Y., Lu Q. Performance of contrast-enhanced cone-beam breast CT to predict nipple-areolar complex involvement in early-stage breast cancer. Eur Radiol. 2025 Jul 1. doi: 10.1007/ s00330-025-11787-8. Epub ahead of print. PMID: 40593168.