The nipple-areola complex is an essential visual feature of the breast, which can be affected during breast surgeries not only directly, but also by producing incidental damage to its vascular pedicle. Tomosynthesis can thoroughly evaluate the vascular pedicles that supply the nipple-areola complex, giving the surgeon the knowledge to choose the appropriate surgical technique that preserve the vessels and avoid possible postoperative complications such as necrosis. This method is not only useful in patients with a surgical history where the anatomy is obviously modified, but also in patients who want surgery for the first time to ensure that there are no anatomical variants that could jeopardize the irrigation of the nipple areola complex.

We describe the technique used in our center with the aim of:

1.- Familiarizing the radiologist with the anatomical aspects of the irrigation of the nipple areola complex and the use of tomosynthesis as the preferred imaging technique. 

2.- Highlight the importance of the indications and the possible consequences of an injury to the vascular pedicle of the areola-nipple complex. 

3.- Describe the typical radiological findings with a standardized report that is useful to the surgeon.