Management Of Ductal Carcinoma
Two types of breast cancer affect the ducts, known as ductal carcinoma in situ and invasive ductal carcinoma. Both types are similar, but ductal carcinoma in situ is non-invasive and confined to its original site, while invasive ductal carcinoma is not limited to the ducts. In most cases, a woman with DCIS can choose between breast-conserving surgery and simple mastectomy. BCS is usually followed by radiation therapy. Lymph node removal is not always needed. It may be done if the doctor thinks the area of DCIS may also contain invasive cancer. The risk of an area of DCIS containing invasive cancer goes up with tumor size and nuclear grade, according to the American Cancer Society.
In the case of invasive ductal carcinoma, patients may need surgery to remove the breast tumor and observe if the disease has reached the lymph nodes. There are two main types of surgery for breast cancer, mastectomy being the most aggressive and breast-conserving surgery the least. Radiation therapy is also an option, since the high-energy rays can reach the breast, chest area, under the arm, and/or the collarbone area, which can be particularly helpful in patients whose cancer has spread. This type of treatment may be administered as external beam radiation, internal partial-breast irradiation, or external partial-breast irradiation.
Problems Caused By Inverted Nipples
Even if a woman is born with inverted nipples, it can be very disconcerting to have this condition. As any gynecologist will tell you, this is a matter of simple genetics, and will generally not cause any problems. However, if inversion is a result of some other change after birth, there may be some more serious problems. An inverted nipple may block a mammary duct, which can mean that when the time comes to feed a newborn baby, a woman with an inverted nipple may not be able to breastfeed.
An inverted nipple can also cause a woman to look and feel older than she is. This is a common problem for aging women, but even if you are not a mature woman, an inverted nipple can give the entire breast an aged appearance.
What Causes Inverted Nipples
You may be wondering what causes this issue and how to fix inverted nipples. Inverted nipples are often congenital, meaning they have been present since birth. This condition may result from milk ducts that do not fully develop or because the nipple base remained small while in the womb. Nipple inversion can occur in both males and females and often affects both sides instead of just one. It is caused by tight connective tissue or other problems with the ductal system connected to the nipple.
Although many people have inverted or retracted nipples since birth, they can also occur late in life. That is known as acquired nipple inversion or retraction. Its causes, which range from mild to severe, can include the following:
- Breast cancer, which can include a rare form that is known as Pagetâs disease
- Fibrocystic breast disease
- Duct ectasia, the widening of a milk duct and the thickening of the walls. It can be a result of the duct filling with fluid and becoming clogged.
- Scarring or loss of fat in the area because of trauma or surgery
- Periductal mastitis, inflammation and infection of a clogged milk duct often caused by duct ectasia.
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Deterrence And Patient Education
Breasts and nipples are an inherent part of the definition of feminity, in addition to functioning to allow breastfeeding. Nipple inversion can not only be functionally deterring to a patient but can have a huge impact on their confidence and self-perception. This can affect pre-teens, teenagers, and adults for varying reasons. Children will quickly realize their nipple look different than their peers’, and may become victims of bullying. As children mature and become sexually active adults, significant effects on intimacy can develop. Some patients are aware of, but not at all bothered by this condition. It is, therefore, important to determine the underlying motivations for a patient presenting for nipple correction. Are these the wishes of the patient, or is the patient feeling external pressure to undergo correction that they otherwise would not have taught is a question that should be addressed?
Should I Consider Inverted Nipple Surgery If I Want To Breastfeed
If you do want to breastfeed, then Nipplettes are the first call. If the nipple will evert with stimulation, then this is encouraging. Slightly more complicated surgery can still be successful even if the nipple is permanently inverted.
If you know that you will not want to breastfeed then surgery is more straightforward as milk ducts can be cut.
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Peeling Scaling Or Flaking Skin
Dont immediately be alarmed if you notice peeling, scaling, or flaking on your breasts or the skin around your nipples. This is a symptom of breast cancer, but it can also be a symptom of atopic dermatitis, eczema, or another skin condition.
After an exam, your doctor may run tests to rule out Pagets disease, which is a type of breast cancer affecting the nipples. It can also cause these symptoms.
Grades Of Nipple Inversion
Nipple inversion is classified by grades, based on how serious the condition is.
- Grade 1. The nipple can easily be pulled outward, and will sometimes stand out on its own with cold or stimulation. You can still breastfeed.
- Grade 2. The nipple can be pulled outward, but it quickly goes back to its original shape. You may have trouble breastfeeding.
- Grade 3. The condition is most severe. You may not be able to pull the nipple out at all or breastfeed.
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Nipple Retraction And Inversion
People can be born with inverted nipples, where the nipples indent inwards, although on stimulation they will generally face outwards. This is completely normal and does not require assessment by a doctor.
Nipple retraction or inversion that is new, occurring only in one breast, or where the nipple does not come out on stimulation can be a concerning sign of breast cancer. This should be discussed immediately with your doctor.
Can Inverted Nipples Be Corrected
The 2020 study published in Plastic and Reconstructive Surgery – Global Open explained that if you don’t like the shape of your nipples, the only way to permanently change them is to have plastic surgery. There are two types: one that keeps the milk ducts intact and one that does not. So, if you are planning to become pregnant and breastfeed, surgery may not be recommended.
Otherwise, there are a few non-invasive strategies that may temporarily alter the shape. A 2020 study published in the International Journal of Health Sciences and Research found that a method called Hoffman’s technique, which includes manipulating the nipple by hand, was effective in fostering successful breastfeeding in mothers with variations in nipple shape.
Also, there are devices that sometimes draw the nipple out from its flat position, including retractors, extractors, and suction devices.
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What Causes An Inverted Nipple
One of the most common causes of an inverted nipple is genetics. Nipple development typically happens in utero around the ninth month, when a pit develops at the skin of the mammary bud. Holes and tubes form within the pit, and the underlying mesoderm increases and raises above the areola. This development process creates a nipple.
A difference in the above development pattern can cause the mesoderm to fail to rise above the areola, resulting in an inverted nipple.
There are certain conditions that can cause you to acquire an inverted nipple later on in life as well.
Skin Rash On The Breasts
You may not associate breast cancer with redness or a skin rash, but in the case of inflammatory breast cancer , a rash is an early symptom. This is an aggressive form of breast cancer that affects the skin and lymph vessels of the breast.
Unlike other types of breast cancer, IBC doesnt usually cause lumps. However, your breasts may become swollen, warm, and appear red. The rash may resemble clusters of insect bites, and its not unusual to have itchiness.
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When To See A Doctor
If you notice a sudden change in the appearance of your nipples, you should consult with your doctor as soon as possible. While it is common for the breasts to change in appearance over time or after breastfeeding, newly inverted nipples are common symptoms of breast cancer. Because there is a higher risk of breast cancer as you get older, it is always a good idea to check with your doctor as soon as you notice any changes in your breasts or nipples.
If you have concerns about breast cancer symptoms, get in touch with the BASS Medical Group. Our medical professionals can perform lab tests and provide consultation when you need it most. Contact us today for more details.
Is Breast Cancer Preventable
Walk The Walk stated that around 40 percent of cancers are preventable equating to 144,000 cases each year.
To help minimise your risk of cancer, the charity recommend eating a healthy diet.
In addition to consuming a good amount of vitamins and minerals, being more active every day is also encouraged.
The Breast Cancer Prevention charity added that to minimise your risk you should drink no or little alcohol.
Moreover, people are advised not to smoke taking in all of these factors, you can reduce your risk of disease.
Added benefits include: better sleep, better physical and mental health, and a lower risk of heart problems.
Certain hormone disrupting chemicals can mimic the natural hormone oestrogen which increases the rate of cell division, added the Breast Cancer Prevention charity.
The more a cell divides the more likely mutations will occur and accumulate, including those associated with breast cancer.
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Inverted Nipple Was Clue To Male Breast Cancer
– October 13, 2021
Growing up, Bob Zvonchenko had two aunts who were diagnosed with breast cancer.But he never imagined that he himself would face the disease.
The diagnosis came very early, Zvonchenko said. It was initially discovered after an ultrasound of my left breast due to some concerns about the sudden appearance of a barely noticeable inverted nipple. I never experienced any pain or other symptoms, so the diagnosis was surprising.
The then 64-year-old had never faced any major health issues. When the ultrasound revealed the tiny mass, Zvonchenko was referred to Moffitt Cancer Center for a biopsy to confirm the diagnosis, ER+/PR+ HER2 breast cancer.
We met with Dr. John Kiluk who recommended a mastectomy to remove the cancer. He was great very knowledgeable and empathetic, Zvonchenko said.
According to the American Cancer Society, breast cancer is most common in women, but men can get breast cancer too. For men, the lifetime risk of getting breast cancer is about 1 in 833. Though male breast cancer is rare, the disease can occur at any age, but it is more prevalent in older men.
Breast cancer symptoms vary based on the specific disease type, but male breast cancer most often presents as a hard lump. Other symptoms may include:
- Nipple pain
- Sores on or near the nipple
- Enlarged lymph nodes under the arm
After surgery and several rounds of chemotherapy, Zvonchenko is finally back to doing what he loves most, boating in the Gulf.
Five Early And Common Nipple Signs
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The earlier breast cancer is detected, the greater the chance of successful treatment and cure, Walk The Walk confirmed.
While a lump in the breast tissue could be a sign of the disease, nine out of 10 breast lump are not cancerous.
Other signs of breast cancer can include:
- Any unusual change in the shape or size of one of your breasts
- If one breast has changed and become lower than the other
- Puckering or dimpling of the skin
- A lump or thickening within the breast or armpit
- Constant pain in one part of the breast.
People are encouraged to check their breasts every month, on the same day.
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For menstruating women, it is advisable to do so immediately after the end of your period.
Trustee of Walk The Walk, Stephen Johnston head of the breast unit at the Royal Marsden NHS Foundation Trust shared his words of advice.
I wanted to take this opportunity to urge those of you that may have any potential symptoms that might indicate breast cancer, to visit your doctor and have a breast check as soon as possible please dont put it off.
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Paget Disease Of The Nipple
Paget disease of the nipple is a very rare form of breast cancer, roughly 1-2% of all new breast cancers diagnosed. It presents as a scaly, raw or ulcerated lesion on the nipple, and can spread to the areola. A bloody discharge may be present, although often it may be clear or yellow.
Pain, a burning sensation and itching of the nipple can be present months before the emergence of the typical ulcerated lesion.
A palpable lump can be felt in roughly 50% of cases, and this will typically be behind or close to the nipple and areola but it can be anywhere in the breast.
How Do I Get My Inverted Nipples To Stick Out
If youre having trouble turning your nipples outward to breastfeed, there are simple techniques you can try to coax them out.
- Hoffmann technique. Place your thumbs on either side of your nipple. Then, press down while pulling your thumbs apart to encourage your nipple to pop up so that your baby can latch.
- Nipples are erectile tissue. Gently place your thumb and forefinger around your nipple and make a rolling motion or apply cold to it to encourage it outward. Side-lying while doing this and feeding your baby can make this even more successful.
- Your baby is often the best tool to draw the nipple out but you can also use a suction device like a breast pump to draw out your nipple. Please note, your baby should be latching onto your areola and not your nipple so often getting a deeper latch can solve latching troubles as well.
If these methods fail, consider consulting a lactation consultant or breastfeeding medicine physician who can provide tips to help your newborn latch correctly so that you can breastfeed.
Enhancing Healthcare Team Outcomes
Nipple inversion is a condition with cosmetic and psychological implications for the patient, and it is best managed with an interprofessional team approach. The treating clinician should be mindful of the primary reason for the correction, whether it is the establishment of functionality or improving the physical appearance. Proper patient counseling regarding the condition, along with the available treatment options, helps them make an informed choice about their management. The most important distinction is between benign, congenital, nipple inversion, and malignancy. There should be a low threshold for the surgeon to obtain a biopsy or other intervention to ensure malignancy is not overlooked.
What Are The Symptoms
Your symptoms will depend on whats causing your inverted nipples.
Signs of inflammation or infection may include:
- Breasts that are tender and warm to the touch.
- Redness in your nipple area.
- A lump behind your nipple.
- Bloody discharge coming from your nipple.
- Discharge from your nipple thats white, green or black.
Signs of cancer may include:
- A lump in your breast.
- Pain in your breast.
- Swelling in your nipples and a discharge.
- Changes in your skin, like dimpling, itchiness, flaky or scaly skin.
Most importantly, pay attention to how quickly your nipple went from facing outward to becoming inverted. Contact your healthcare provider if the change was sudden.
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Symptoms Of Breast Cancer
When noticing any changes in your normal body function or appearance, getting it checked out with a medical professional immediately is always wise. Kirsty has had it rough, but she likely caught her cancer just in time.
In addition to symptoms like Kirstys with an inverted nipple, be on the lookout for:
- A new breast lump
- New swelling in one breast
- Changes in the nipple or breast
- Redness or flaking in the nipple or breast
- Discharge from the nipple
- Pain in the breast
Manchester Evening News
Kirsty then started the whirlwind process that most cancer patients can identify with following their diagnosis. She had a single mastectomy, which is the removal of the breast, and started chemotherapy, which took a major toll on her body. People often report different levels of reaction and side effects to treatment, but Kristys was on the extreme side. She suffered from neutropenic sepsis, which is a life-threatening whole-body reaction.
Inverted Nipple Surgery At The Private Clinic
The Private Clinic sees over 15,000 new patients every year and performs over 10,000 procedures, with one of the highest patients satisfaction in the sector, Trustpilot 9.4, 5-star rating, 93% would recommend us to their friends and family. We are a multi-award winning provider and have been voted the Aesthetic award for Best UK Clinic Group 2017. The Private Clinic prides itself on its commitment to Medical Expertise, Patient Care and Satisfaction, Honest advice and most importantly Results. We are above all committed to Quality. Please feel free to contact us for any advice or to book a consultation with one of our expert Breast surgeons.
At The Private Clinic, Nipple Surgery is one of our specialisms, and we have a number of expert surgeons who offer the treatment. For more information on any of the nipple surgery procedures above, or to book a consultation, please contact us on 0333 920 2471 or use our online contact form.