Identifying Conditions Affecting a Woman’s Nipple

Fissure of the Nipple
This is the most common ailment suffered by women; the fissure of the nipple is a longitudinal ulcer that tends to develop in any woman who is nursing a baby. The ulcer is irritated constantly by the act of suckling and causes the mother considerable pain, often associated with bleeding of the nipple. Prophylactic treatment, cleanliness and washing and drying of the nipple after each nursing usually prevent the occurrence of this condition.

In the prenatal period, the woman can wash, dry and lubricate the nipples in preparation for nursing, thereby helping to prevent fissure development. If a fissure develops, it should be washed at frequent intervals with sterile saline solution, and nursing should continue only with the use of an artificial nipple. If healing does not occur promptly, or if the case is severe and painful, nursing should be stopped and a breast pump substituted for it. Persistent ulceration suggests carcinoma or a primary luetic lesion. Bleeding or

Bloody Discharge from the Nipple
At times, a bloody discharge may be noted on the clothes, which upon investigation is found to be coming from the nipple. Often, there may be one area at the edge of the areola where pressure produces the discharge. Although a bloody nipple discharge may occasionally be caused by malignancy, it is most commonly due to a wart-like papilloma growing in one of the larger collecting ducts just at the edge of the areola.

This bleeds on trauma and the blood collects in the duct until it is pressed out at the nipple. The duct can be identified in the nipple and traced down, so that the duct and the papilloma can be excised through a small periareolar incision.

Paget’s disease
This disease of the nipple is seen most frequently in women over 40; usually, it is unilateral. Most often it begins as a mild eczematoid condition of the nipple that may spread over the areola and even part of the breast; later, it may become ulcerated or eroded. In the more advanced stages, there may be retraction of the nipple. This is a true carcinoma of the ducts of the breast that converge at the nipple.

When any lesion of the nipple has not healed after a few weeks of treatment by simple cleansing and protective measures, a suspicion of Paget’s disease should be confirmed by biopsy examination. This disease demands early and total removal of the mammary gland.

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