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DefinitionNipple problems can include tenderness or discharge from the nipple portion of the breast. (See also intraductal papilloma .)
Causes, incidence, and risk factors
Nipple tenderness may be caused by inadequate lubricant secretion by the sebaceous glands of the areolar region of the breast or from irritation of the skin from constant excessive moisture that may occur in breastfeeding women. Bacterial or fungal infection of the nipple may also cause nipple tenderness. Tenderness may also result from local trauma or friction over the area.
A milky-appearing nipple discharge may normally occur during pregnancy, shortly after delivery, or in breastfeeding women. It may also be caused by a variety of endocrine disorders.
Chlorpromazine-type drugs and birth control pills may also cause a milky nipple discharge. Abnormal nipple discharge may be caused by breast cancer (least common cause), intraductal papilloma , and mammary dysplasia with ectasia of the ducts (most common cause).
Signs and tests
A careful history and physical examination should be performed.
Treatment depends upon an accurate diagnosis of the cause. It may range from observation and reassurance, to prescribing medications, to surgery or other treatments.
Most causes of nipple problems do not involve breast cancer and can be managed or resolved with adequate treatment.
A nipple discharge may be a symptom of breast cancer .
Calling your health care provider
Call for an appointment with your health care provider if nipple problems occur.
Breastfeeding women should be taught to clean the breasts well before and after feedings and to use breast pads to help maintain dryness between feedings. Breast creams may be used to help keep the nipple area lubricated and supple.
Update Date: 2/7/2002Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT