ASK THE DOC­TOR... “Are nip­ple changes a concern?”

Sunday Herald Sun - Body and Soul - - B+S MEDICAL - WITH DR CINDY PAN


I have no­ticed changes to one of my nip­ples. It is flaky, scaly, red and itchy. Some­times there is tin­gling and burn­ing and it is sen­si­tive. Could this be any­thing to worry about?

While it is pos­si­ble flaky, scaly, itchy or sen­si­tive skin on the nip­ple could be caused by eczema or der­mati­tis, it can also be a con­di­tion called Paget’s disease of the nip­ple, a type of breast cancer that forms around the nip­ple.

It is rel­a­tively rare, ac­count­ing for less than five per cent of all breast can­cers, and is mostly found in women over 50. How­ever, women have been di­ag­nosed in their 20s.

Early symp­toms in­clude red­ness, scal­ing, flak­ing and ir­ri­ta­tion. More ad­vanced


symp­toms in­clude tin­gling, itch­ing, sen­si­tiv­ity, burn­ing and pain. There may be a dis­charge or bleed­ing and the nip­ple may be­come hard, lumpy, flat­tened, in­drawn or in­verted. In some cases there may also be a breast lump and un­der­ly­ing breast cancer.

If you no­tice any changes to one or both nip­ples, see your doc­tor as soon as pos­si­ble. It may not be any­thing se­ri­ous, but if your doc­tor sus­pects Paget’s disease, a biopsy can be per­formed, where a small sam­ple of the skin tis­sue and any dis­charge is ex­am­ined.

You may also need a mam­mo­gram and ul­tra­sound to check for un­der­ly­ing cancer.

Treat­ment of Paget’s disease of the nip­ple varies de­pend­ing on how ad­vanced, in­va­sive or ag­gres­sive the cancer is. Your doc­tor will talk to you about your op­tions. For very early cancer it may be pos­si­ble to re­move just the nip­ple and af­fected area of breast fol­lowed by ra­di­a­tion ther­apy. In other cases the whole breast and lymph nodes may need to be re­moved.

As with any cancer, the sooner you get your­self checked out, the more treat­ment op­tions you may have and the more likely they are to be suc­cess­ful.

Don’t ig­nore any health con­cerns, es­pe­cially breast or nip­ple changes.


Read Dr Cindy Pan’s ar­ti­cle on three other nip­ple con­di­tions at bodyand­

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