Clinical and Sonomammographical Correlations between the Distance from the Tumor to the Nipple–Areola Complex and Pathological Axillary Nodal Involvement in Carcinoma in Breast Patients

Abstract Background: Breast cancer is the most prevalent malignancy among women worldwide, accounting for 12.5% of all new cancer cases. Early detection and staging are crucial for improving outcomes. Recent studies suggest that tumor proximity to the nipple–areola complex (NAC) may influence axillary lymph node involvement (ALNI). Tumors closer to the NAC may be more likely to metastasize due to preferential drainage into axillary lymphatics. This study aimed to assess the correlation between tumor-to-NAC (T-NAC) distance and axillary nodal positivity. Materials and Methods: This cross-sectional, observational study included breast carcinoma patients who underwent clinical, mammographical, and ultrasonographical evaluation for measurement of T-NAC distance. Tissue sampling and needle biopsies were performed as a means of triple assessment, and positive diagnosis was confirmed with immunohistochemical analysis. A multidisciplinary team reviewed the findings, and eligible patients who underwent surgical intervention were included. Postsurgery, specimens were analyzed histopathologically. Results: The clinical, sonomammographical distance between tumor and the NAC had a significant association with axillary lymph node positivity ( P < 0.001). Patients with lymph nodes positive for malignancy had a shorter tumor to NAC distance compared to those without positive for malignancy ( P = 0.004 for clinical, P = 0.003 for ultrasonographic, and P < 0.001 for mammographic measurements). Conclusion: T-NAC distance can serve as a prognostic indicator in breast cancer, with short distances linked to an increased risk of axillary lymph node involvement. Such findings could help in preoperative risk assessment and enhance surgical and oncological treatment strategies. However, further studies are needed to confirm our hypotheses and assess long-term outcomes.