Nipple disorders

Problems that affect the nipple, the site on the breast into which the ducts of the 15-20 separate breast glands discharge. A normal variant is a nipple which has been retracted since birth; this may occur on one or on both sides. The same is also true of the additional nipples which can occur in the line from the armpit to the groin. If a nipple suddenly retracts, this may indicate that the milk passages or the breast tissue are affected. A biopsy is usually necessary in order to determine the nature of the condition. Cracks in the nipple are rare except in breast-feeding mothers. Redness and scales on the nipple and the surrounding area can indicate an allergic reaction in the skin. This usually occurs on both sides; when it is present only on one side it may be a sign of a malignant growth in the milk ducts under the nipple. Secretions from the nipple of varying colour and occurring in one or both nipples may arise. A milk-like secretion occurring with women of child-bearing age is usually bilateral. It may be caused by a disturbance in the hormonal balance of the hypothalamus and the pituitary. Taking certain medicines, notably antidepressants and the contraceptive pill, can also give rise to a milk-like secretion. Abnormal secretions from the breast, such as bloody, flesh-coloured or yellowish-green secretions, are a sign of a disorder in the milk passages or lactiferous glands and further examinations (mammography, contrast X-rays or biopsy) are usually required in order to determine whether the condition is benign or malignant.