To review the sonographic and elastographic features of retroareolar carcinomas.

Institutional review board approval was obtained. Among 967 sonographically guided biopsies (2013–2014) (14-gauge cores), 53 yielded the diagnosis of retroareolar carcinoma (located less than 2 cm from the nipple on mammograms). Out of these 53 lesions, 30 were assessed additionally with strain elastography prior to the biopsy in addition to conventional sonographic analysis. Imaging features were analyzed in consensus by two radiologists. Elasticity score was evaluated by the score defined by Itoh (Tsukuba score). Descriptive analysis was performed.

A total of 30 lesions were included (30 patients; mean age, 66.03 (±12.88)). The mean size of the lesions at diagnosis was 23.97 mm (±13.64). Sonographically, most of lesions appeared as hypoechoic masses (96.5%, 28/29) displaying an irregular shape (75.9%, 22/29), non parallel orientation (58.6%, 17/29), non circumscribed margins (86.2%, 25/29), posterior attenuation (93.3%, 28/29). Among the 30 lesions, 3.3% (1/30) of lesions appeared as an attenuation and distortion without discrete mass. Most of the lesions were categorized as BI-RADS category 5 (76.7%, 23/30). Approximately half of lesions (53.3%, 16/30) appeared as firm and larger than 2D mode with strain elastography according to the Tsukuba score.

Retroareolar carcinoma displayed malignant features at US and elastographic examination. In our study population, the addition of elastography to breast US in this location did not improve diagnostic accuracy.