71 Beyond the Surface: Suspicious Nipple Lesions

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement42nd Annual Miami Breast Cancer Conference® - Abstracts
Volume 39
Issue 4
Pages: 54-55

71 Beyond the Surface: Suspicious Nipple Lesions

71 Beyond the Surface: Suspicious Nipple Lesions

Background/Significance

Nipple lesions, often subtle and easily overlooked, can represent early signs of malignancy, which should prompt pathologic evaluation. These reports highlight the importance of heightened visual interpretation for timely diagnosis and treatment.

Materials and Methods

Cases from a breast surgery tertiary referral hospital illustrate suspicious nipple lesions in 1 male and 4 female individuals.

Results

Case 1: A 46-year-old woman presented with 6 months of painful, spontaneous milky discharge in the left breast with an associated 5-mm yellow nipple scab. Breast mammogram and ultrasound were benign. Shave biopsy revealed breast primary adenocarcinoma. MRI showed diffuse enhancement with nipple-areola complex (NAC) retraction. Lumpectomy confirmed invasive ductal carcinoma (IDC).

Case 2: A 61-year-old woman with persistent right nipple itching, scaling, shape deviation, hyperpigmentation, and a palpable retroareolar mass. Breast imaging showed retroareolar intraductal mass. Final surgical pathology revealed ductal carcinoma in situ (DCIS) and Paget disease.

Case 3: A 70-year-old man with an enlarging verrucous, pruritic left nipple lesion with an associated palpable retroareolar mass. Breast mammogram revealed a 2.6-cm mass, which extended to the nipple, with enlarged ipsilateral axillary lymph nodes. Biopsy confirmed IDC.

Case 4: A 63-year-old woman with right nipple inversion, hyperpigmentation, crusting, and a palpable mass. History of papillary carcinoma resected with clear margins 10 years ago. Ultrasound showed central right breast mass. Ultrasound-guided biopsy revealed atypical ductal hyperplasia. Nipple punch biopsy revealed papillary carcinoma. Mastectomy with sentinel node evaluation confirmed IDC with negative nodes.

Case 5: A 36-year-old woman with a 3-year history of bilateral areolar skin thickening and hyperpigmentation. No scaling, discharge, or pruritus. Bleeding occurred when a lesion was scratched. Breast imaging was benign. Punch biopsy revealed hyperkeratosis of the NAC and possible correlation with T-cell lymphoma.

Conclusion

Meticulous examination of nipple abnormalities is critical in early detection. Clinicians must maintain a high index of suspicion and consider tissue diagnosis for concerning nipple changes.

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2 Preventive Care and Screening Adherence Among Women Surviving Breast Cancer
2 Preventive Care and Screening Adherence Among Women Surviving Breast Cancer
3 Intraoperative Radiotherapy: Alive and Well in the Bronx
3 Intraoperative Radiotherapy: Alive and Well in the Bronx
4 Evaluating AI-Driven Responses in Breast Reconstruction: A Comparative Study of Response Formats
4 Evaluating AI-Driven Responses in Breast Reconstruction: A Comparative Study of Response Formats
5 Correlation Between Visual Impairment and Breast Cancer: A Cross-Sectional Study Based on the National Health Interview Surveys
5 Correlation Between Visual Impairment and Breast Cancer: A Cross-Sectional Study Based on the National Health Interview Surveys
6 Peer Support Programming Among Women At-Risk for Surviving Breast Cancer: Facilitators and Barriers to Community-Based Patient Navigation and the Role of Quality of Life
6 Peer Support Programming Among Women At-Risk for Surviving Breast Cancer: Facilitators and Barriers to Community-Based Patient Navigation and the Role of Quality of Life
7 Metaplastic Breast Cancer: A Retrospective Chart Review of Clinical Features
7 Metaplastic Breast Cancer: A Retrospective Chart Review of Clinical Features
8 A Case Series Exploring Characteristics and Outcomes of Metachronous Primary Breast and Lung Cancer in a Diverse Cohort
8 A Case Series Exploring Characteristics and Outcomes of Metachronous Primary Breast and Lung Cancer in a Diverse Cohort
9 Body Mass Index, Cancer Risk Behaviors, and Readiness for Dietary Change Among Women Surviving With Breast Cancer
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10 AI as a Bridge: Can ChatGPT Help Patients Understand Their Breast Radiology Reports?
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12 Gut Microbiome Composition and Pathological Complete Response After Chemotherapy in Breast Cancer: Insights From a Pilot Study
12 Gut Microbiome Composition and Pathological Complete Response After Chemotherapy in Breast Cancer: Insights From a Pilot Study
13 Preliminary Analysis of Change During Treatment of Financial Toxicity and Quality of Life in Breast Cancer Patients
13 Preliminary Analysis of Change During Treatment of Financial Toxicity and Quality of Life in Breast Cancer Patients
15 Utilizing Circulating Tumor Cells to Guide HER2-Directed Therapy in IHC/FISH-Negative HER2+ Metastatic Breast Cancer
15 Utilizing Circulating Tumor Cells to Guide HER2-Directed Therapy in IHC/FISH-Negative HER2+ Metastatic Breast Cancer
16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
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