{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:47:24Z","timestamp":1785919644393,"version":"3.56.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["22176195"],"award-info":[{"award-number":["22176195"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2021A1515010171"],"award-info":[{"award-number":["2021A1515010171"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"abstract":"\n Objectives<\/jats:title>\n To compare the diagnostic performance of conventional ultrasonography (US) combined with contrast\u2010enhanced ultrasonography (CEUS) versus dynamic contrast\u2010enhanced magnetic resonance imaging (DCE\u2010MRI) in preoperatively predicting nipple\u2010areolar complex (NAC) involvement in breast cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n From January 2020 to November 2024, patients with primary breast cancer confirmed by preoperative biopsy were consecutively enrolled in this study. All patients underwent CEUS and DCE\u2010MRI examinations before operation. NAC involvement status was determined by subareolar intraoperative biopsy and postoperative pathology. LASSO regression was used to screen the US and DCE\u2010MRI predictors most related to NAC involvement, and nomograms were constructed accordingly. The data were bootstrapped 500 times for internal verification, and a calibration curve was generated to verify the prediction ability. The area under the receiver operating characteristic curve (AUC) of the 2 models was compared using the DeLong test.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We prospectively included 126 primary breast cancer lesions from 124 women in this study: 26 lesions (20.6%) with NAC involvement and 100 lesions (79.4%) without NAC involvement. The AUC of the US\u2010CEUS model for diagnosing NAC involvement was significantly higher than that of the DCE\u2010MRI model (0.893 versus 0.817,\n p<\/jats:italic>\n \u2009=\u2009.047).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n US combined with CEUS demonstrated significantly higher diagnostic performance than DCE\u2010MRI in the preoperative prediction of NAC involvement. This supports its role as a valuable complementary tool for identifying candidates for nipple\u2010sparing mastectomy (NSM), particularly in patients with contraindications to gadolinium\u2010based contrast agents or in settings where MRI is unavailable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jum.70406","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:08:12Z","timestamp":1785917292000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Performance of Conventional Combined with Contrast\u2010Enhanced Ultrasonography Versus Dynamic Contrast\u2010Enhanced Magnetic Resonance Imaging for Preoperative Prediction of Nipple\u2010Areolar Complex Involvement in Breast Cancer<\/scp>"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6669-3124","authenticated-orcid":false,"given":"Peng","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Guangxi Medical University Nanning China"},{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8254-8853","authenticated-orcid":false,"given":"Jingwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2129-2834","authenticated-orcid":false,"given":"Yuqin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiajing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunchun","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7530-2607","authenticated-orcid":false,"given":"Jianghao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guowen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1765-6423","authenticated-orcid":false,"given":"Chao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Institute of Scientific Instrumentation Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongpan","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Thyroid and Breast Surgery The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghui","family":"Ran","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinshu","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Guangxi Medical University Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1279-100X","authenticated-orcid":false,"given":"Jianjun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasound The First People's Hospital of Qinzhou Qinzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9873-1631","authenticated-orcid":false,"given":"Hong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital of Guangxi Medical University Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/jamasurg.2013.3049","article-title":"Effect of breast conservation therapy vs mastectomy on disease\u2010specific survival for early\u2010stage breast cancer","volume":"149","author":"Agarwal S","year":"2014","journal-title":"JAMA Surg"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1245\/s10434-019-07948-x","article-title":"Increase in utilization of nipple\u2010sparing mastectomy for breast cancer: indications, complications, and oncologic outcomes","volume":"27","author":"Valero MG","year":"2020","journal-title":"Ann Surg Oncol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/PRS.0000000000003505","article-title":"Quality\u2010of\u2010life outcomes improve with nipple\u2010sparing mastectomy and breast reconstruction","volume":"140","author":"Bailey CR","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1111\/tbj.12542","article-title":"Psychosocial and sexual well\u2010being following nipple\u2010sparing mastectomy and reconstruction","volume":"22","author":"Wei CH","year":"2016","journal-title":"Breast J"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"4948","DOI":"10.1200\/JCO.2008.20.8785","article-title":"Occult nipple involvement in breast cancer: clinicopathologic findings in 316 consecutive mastectomy specimens","volume":"27","author":"Brachtel EF","year":"2009","journal-title":"J Clin Oncol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1016\/j.ejso.2018.07.059","article-title":"Nipple\u2010sparing mastectomy: reliability of sub\u2010areolar sampling and frozen section in predicting occult nipple involvement in breast cancer patients","volume":"44","author":"D'Alonzo M","year":"2018","journal-title":"Eur J Surg Oncol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/bjc.1989.15","article-title":"Cancer of the breast with nipple involvement","volume":"59","author":"Menon RS","year":"1989","journal-title":"Br J Cancer"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1245\/s10434-012-2641-7","article-title":"Predicting nipple\u2010areolar involvement using preoperative breast MRI and primary tumor characteristics","volume":"20","author":"Steen ST","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.4048\/jbc.2014.17.4.386","article-title":"Magnetic resonance imaging and clinicopathological factors for the detection of occult nipple involvement in breast cancer patients","volume":"17","author":"Byon W","year":"2014","journal-title":"J Breast Cancer"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/jso.26725","article-title":"Locoregional recurrence in skin\u2010sparing and nipple\u2010sparing mastectomies","volume":"125","author":"Costeira B","year":"2022","journal-title":"J Surg Oncol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"2535","DOI":"10.1016\/j.bjps.2021.05.030","article-title":"Impact of local breast cancer recurrence on reconstructed breast in nipple\u2010sparing mastectomy with immediate reconstruction","volume":"75","author":"Wu ZY","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-026-19808-6"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20190074","article-title":"Use of preoperative mammography, ultrasonography, and MRI to predict nipple areolar complex involvement in breast cancer","volume":"92","author":"Lim S","year":"2019","journal-title":"Br J Radiol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3348\/kjr.2022.0846","article-title":"Diagnostic accuracy of magnetic resonance imaging features and tumor\u2010to\u2010nipple distance for the nipple\u2010areolar complex involvement of breast cancer: a systematic review and meta\u2010analysis","volume":"24","author":"Byon JH","year":"2023","journal-title":"Korean J Radiol"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejrad.2019.108754","article-title":"MRI diagnostic features for predicting nipple\u2010areolar\u2010complex involvement in breast cancer","volume":"122","author":"Koh J","year":"2020","journal-title":"Eur J Radiol"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1148\/radiol.2021204136","article-title":"Diagnostic accuracy of nonmass enhancement at breast MRI in predicting tumor involvement of the nipple: a prospective study in a single institution","volume":"301","author":"Bae SJ","year":"2021","journal-title":"Radiology"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"448","DOI":"10.2214\/AJR.12.9186","article-title":"Malignant invasion of the nipple\u2010areolar complex of the breast: usefulness of breast MRI","volume":"201","author":"Moon JY","year":"2013","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s40263-018-0500-1","article-title":"Gadolinium\u2010based contrast agent\u2010related toxicities","volume":"32","author":"Pasquini L","year":"2018","journal-title":"CNS Drugs"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1148\/radiol.2019182947","article-title":"Breast MRI: state of the art","volume":"292","author":"Mann RM","year":"2019","journal-title":"Radiology"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.251350","article-title":"Tumor involvement of the nipple at preoperative contrast\u2010enhanced mammography: a multicenter diagnostic accuracy study","volume":"317","author":"Cozzi A","year":"2025","journal-title":"Radiology"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1148\/radiol.211347","article-title":"Contrast\u2010enhanced US of the liver and kidney: a problem\u2010solving modality","volume":"303","author":"Atri M","year":"2022","journal-title":"Radiology"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1016\/j.ultrasmedbio.2023.08.023","article-title":"A nomogram based on conventional and contrast\u2010enhanced ultrasound for pre\u2010operative prediction of nipple\u2010areola complex involvement in breast cancer: a prospective study","volume":"49","author":"Fang J","year":"2023","journal-title":"Ultrasound Med Biol"},{"key":"e_1_2_8_24_1","volume-title":"Breast imaging reporting and data system: ACR BI\u2010RADS Breast Imaging Atlas","author":"D'Orsi CJ","year":"2013"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"3683","DOI":"10.1007\/s00330-020-07550-w","article-title":"MIP image derived from abbreviated breast MRI: potential to reduce unnecessary sub\u2010nipple biopsies during nipple\u2010sparing mastectomy for breast cancer","volume":"31","author":"Liu Z","year":"2021","journal-title":"Eur Radiol"},{"key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.2214\/AJR.15.15187","article-title":"MRI to predict nipple involvement in breast cancer patients","volume":"206","author":"Piato JR","year":"2016","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.clinimag.2015.08.002","article-title":"Can preoperative 3\u2010T MRI predict nipple\u2010areolar complex involvement in patients with breast cancer?","volume":"40","author":"Cho J","year":"2016","journal-title":"Clin Imaging"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.crad.2018.03.008","article-title":"Preoperative MRI evaluation of lesion\u2010nipple distance in breast cancer patients: thresholds for predicting occult nipple\u2010areola complex involvement","volume":"73","author":"Mariscotti G","year":"2018","journal-title":"Clin Radiol"},{"key":"e_1_2_8_29_1","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1177\/0284185116683574","article-title":"Non\u2010mass breast lesions on ultrasound: final outcomes and predictors of malignancy","volume":"58","author":"Park JW","year":"2017","journal-title":"Acta Radiol"},{"key":"e_1_2_8_30_1","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ejrad.2014.10.010","article-title":"Non\u2010mass\u2010like breast lesions at ultrasonography: feature analysis and BI\u2010RADS assessment","volume":"84","author":"Ko KH","year":"2015","journal-title":"Eur J Radiol"},{"key":"e_1_2_8_31_1","first-page":"244","article-title":"Involvement of the nipple in early carcinoma of the breast","volume":"168","author":"Suehiro S","year":"1989","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_8_32_1","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1055\/a-0586-1107","article-title":"The EFSUMB guidelines and recommendations for the clinical practice of contrast\u2010enhanced ultrasound (CEUS) in non\u2010hepatic applications: update 2017 (long version)","volume":"39","author":"Sidhu PS","year":"2018","journal-title":"Ultraschall Med"},{"key":"e_1_2_8_33_1","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1007\/s00259-010-1537-7","article-title":"Imaging of perfusion using ultrasound","volume":"37","author":"Cosgrove D","year":"2010","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"e_1_2_8_34_1","doi-asserted-by":"crossref","DOI":"10.1186\/s43055-021-00516-y","article-title":"Prediction of nipple\u2010areolar complex involvement by breast cancer: role of dynamic contrast\u2010enhanced magnetic resonance imaging (DCE\u2010MRI)","volume":"52","author":"EL\u2010Adalany MA","year":"2021","journal-title":"Egypt J Radiol Nucl Med"},{"key":"e_1_2_8_35_1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s12282-012-0338-1","article-title":"Is MRI useful for the prediction of nipple involvement?","volume":"20","author":"Sakamoto N","year":"2013","journal-title":"Breast Cancer"},{"key":"e_1_2_8_36_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1148\/radiol.2020203245","article-title":"Recognizing the role of the reticuloendothelial system in the late phase of US contrast agents","volume":"298","author":"Khalili K","year":"2021","journal-title":"Radiology"},{"key":"e_1_2_8_37_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/978-3-030-79256-5_7","volume-title":"Medical Imaging Contrast Agents: A Clinical Manual","author":"Yigitaslan S","year":"2021"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70406","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.70406","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T08:08:17Z","timestamp":1785917297000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.70406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":36,"alternative-id":["10.1002\/jum.70406"],"URL":"https:\/\/doi.org\/10.1002\/jum.70406","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]},"assertion":[{"value":"2026-03-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jum.70406"}}