Nipple Problems

Nipple Problems

What is the difference between a retracted nipple and an inverted nipple?

A retracted nipple is one which is pulled inward from time to time. It is not permanently turned inwards.

It can be brought out by manipulation with the fingers and it is also brought out by cold weather.

An inverted nipple is one which is permanently turned inwards. This is due to the fact that it is connected to a short milk (lactiferous) duct. Breast function is not affected and the nipple does not usually require medical attention.

If you notice your nipple turning inwards or being pulled to one side, you should discuss this with your doctor. This may be just a normal feature of ageing, however you your doctor will probably suggest a mammogram (X-ray of the breast) to rule out any possible underlying cause such as cancer.

Should I be worried about nipple discharge?

Not usually. Nipple discharge is a fairly common complaint, even among women who are not pregnant. Most discharge from the nipple is not serious.

The discharge can come from the ducts underneath the nipple or from the surface of the nipple itself.

A common type of discharge amongst women who have had babies is a milky discharge, which can continue months or even years after the woman has stopped breastfeeding. In rare cases, a woman who has never been pregnant can also have a milky discharge from her nipples.

All woman, whether pregnant or not, have fluid in their breasts. This fluid does not usually 'leak' because the ducts in the breasts are blocked with plugs of a substance called keratin.

Sometimes these plugs are dislodged, for example after exercise, allowing the fluid to be released. The amount that is discharged is usually very small. It may be white, yellow, green, blue or black.

Older women may also experience a discharge that is cheesy in appearance. This occurs because as a woman gets older, her ducts widen and become filled with a cheese-like material, which can sometimes leak.

When should I be concerned about nipple discharge?

If the discharge is in large quantities and is constant, it could be a sign of duct disease. A persistent milky discharge may be a sign of overactivity of the pituitary gland in the brain, resulting in high levels of the hormone prolactin which may be causing the nipple discharge. This can be diagnosed by checking the prolactin levels in a blood test. If the prolactin level is elevated, it will usually be treated with medications.

A discharge that is bloodstained may be caused by a wart in one of the ducts underneath the nipple. This type of wart is known as a papilloma (benign/non-cancerous growth). In such cases, removal of the duct involved solves the problem. This is a simple procedure.

If the discharge is coming from the surface of the nipple or from the surrounding skin, Paget's disease may be the cause. This disease resembles eczema on the skin and may cause an ulcer on the surface of the nipple. Paget's disease is usually a sign that there is a slow growing cancer or a pre-cancer in the breast. (This should not be mixed up with a chronic disease of the bones, also known as Paget's disease.) Surgical treatment is required.

If you notice anything strange about your discharge or are in any way worried, visit your doctor immediately.

I have a third nipple. Should I be worried?

No. Third nipples, or supernumerary nipples, are more common than people think.

They tend to stay smaller than the main nipples and very rarely need to be removed for medical reasons. It is more likely that a person will have it removed because the appearance causes them some embarrassment.

However if you notice any changes in the third nipple or simply want to have it checked out, visit your doctor to have it checked out.

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