NIPPLE CHANGES
Nipple Inversion and Retraction
Inverted nipples are nipples that point inward, rather than pointing out. There are many causes of nipple inversion.
Normal Variation
Inverted nipples can be a normal variation of nipple type. Some people are born with inverted nipples. Nipple inversion can also occur slowly and gradually with age. Inverted nipples that are not caused by a medical condition do not require treatment. Surgery
can be performed to correct an inverted nipple for aesthetic reasons.
Duct Ectasia
Duct ectasia is a benign condition in which there is enlargement and inflammation of the ducts under the nipple. It usually occurs in women after menopause. Duct ectasia can also cause nipple discharge. In most cases, no treatment is required. If the discharge is a nuisance, the ducts behind the nipple can be removed surgically.
Paget's Disease of the Nipple
Paget's disease of the nipple is an uncommon type of breast cancer in which cancer cells grow in the nipple-areolar complex. Paget’s disease causes the nipple skin to become red, painful, scaly and sometimes ulcerated, and it may be associated with blood-stained or clear nipple discharge.
Breast Cancer
Nipple inversion that occurs suddenly always requires investigation with the triple test, as it could be a sign of breast cancer
forming underneath and pulling the nipple inwards. Around 8% of women with breast cancer present with nipple changes.
Skin Changes of the Nipple
There are many causes of skin changes of the nipple.
Nipple Eczema
Eczema or dermatitis affecting the skin of the nipple, particularly if it becomes infected, can cause a weeping discharge associated with crusting of the nipple. Punch biopsies of the affected skin may be required to rule out Paget's disease. Treatment is with steroid based creams, the same as for eczema elsewhere in the body.
Paget's Disease of the Nipple
Paget's disease of the nipple is an uncommon type of breast cancer in which cancer cells grow in the nipple-areolar complex. Paget’s disease causes the nipple skin to become red, painful, scaly and sometimes ulcerated, and it may be associated with blood-stained or clear nipple discharge.
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