If you notice any of the following changes, see your doctor.
Inflammation, thickening, cracking or flaking of the skin
Nipple and areola skin can be affected by any conditions that affect the skin of the rest of the body, and nipples are prone to skin conditions such as eczema. Because nipple skin is more delicate and has a greater nerve supply, it tends to become redder, more swollen and more painful than other skin. There is an uncommon type of cancer called Paget’s disease of the breast in which cancer in a duct beneath spreads to the outside through the nipple. This occurs mainly in postmenopausal women. At first one nipple and areola become itchy or sore. Later the skin may become cracked, weeping and crusted. Treatment is the same as for other types of breast cancer.
Lumps
There are many sebaceous glands near the edge of the areola and at the base of the nipple. Occasionally the duct of one of these glands becomes blocked, resulting in a pimple-like lump that will usually discharge spontaneously and settle down within a few days. If not, or if inflammation spreads around the base of the lump, see your doctor.
You may notice a yellowish, grey, brown or green discharge on your bra. Most causes are benign, and include overgrowth of the lining cells or cystic dilatation of the ducts beneath the nipple.
Milk discharge in a woman who isn’t breast-feeding can result from stimulation or sucking of nipples during sexual activity. Rarely is it the result of overproduction of prolactin by the pituitary gland, which often goes with menstrual irregularities or amenorrhoea. Consult your doctor about any sort of nipple discharge to see whether further tests or treatments are needed.
Inversion of a previously everted nipple
This may be due to benign inflammation of ducts behind the nipple, resulting in scar tissue that contracts and pulls the nipple inwards. In some types of breast cancer the nipple may be pulled in or up, or a dimple may form in the areola. Full investigation is necessary in all new nipple inversions to rule out the possibility of cancer.
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