Nipple adenoma in a female patient presenting with persistent erythema of the right nipple skin: case report, review of the literature, clinical implications, and relevancy to health care providers who evaluate and treat patients with dermatologic conditions of the breast skin.

Gina P Spohn,Shannon C Trotter,Stephen P Povoski,Gary Tozbikian

doi:10.1186/s12895-016-0041-6

Gina P Spohn, Shannon C Trotter + Show 2 more

Open Access

https://doi.org/10.1186/s12895-016-0041-6

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Abstract

BackgroundNipple adenoma is a very uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, it often presents as a palpable nipple nodule, a visible nipple skin erosive lesion, and/or with discharge from the surface of the nipple skin, and is primarily seen in middle-aged women. Resultantly, nipple adenoma can clinically mimic the presentation of mammary Paget’s disease of the nipple. The purpose of our current case report is to present a comprehensive review of the available data on nipple adenoma, as well as provide useful information to health care providers (including dermatologists, breast health specialists, and other health care providers) who evaluate patients with dermatologic conditions of the breast skin for appropriately clinically recognizing, diagnosing, and treating patients with nipple adenoma.Case presentationFifty-three year old Caucasian female presented with a one year history of erythema and induration of the skin of the inferior aspect of the right nipple/areolar region. Skin punch biopsies showed subareolar duct papillomatosis. The patient elected to undergo complete surgical excision with right central breast resection. Final histopathologic evaluation confirmed nipple adenoma. The patient is doing well 31 months after her definitive surgical therapy.ConclusionsSince nipple adenoma represents a benign proliferative process of the nipple, complete surgical excision is curative. However, the coexistence of nipple adenoma and ipsilateral or contralateral breast cancer is well reported in the literature. The potential for a direct causal link or association of nipple adenoma and breast cancer cannot be fully excluded.

Highlights

Nipple adenoma is a very uncommon, benign proliferative process of lactiferous ducts of the nipple
The coexistence of nipple adenoma and ipsilateral or contralateral breast cancer is well reported in the literature
nipple adenoma (NA) is a very uncommon condition of the breast, primarily seen in middle-aged women, and representing a benign proliferative process of lactiferous ducts of the nipple [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130]. It often presents as a palpable nipple nodule, a visible nipple skin erosive lesion, and/or with discharge from the surface of the nipple skin

Summary

Conclusions

NA is a benign proliferative lesion of the nipple. NA can be an important clinical mimic of mammary Paget’s disease of the nipple. Since NA is an uncommon and likely under-recognized phenomenon, it is important to continue reporting on new NA cases and to closely follow those patients over time. Such an approach may be useful for allowing us to continue to learn more about its natural history and for attempting to clarify the question of any potential direct causal link or association of NA and breast cancer. In light of our inability to exclude a direct causal link or association of NA and breast cancer, it is very reasonable to encourage patients with a history of NA to maintain regular breast follow-up with continuation of annual clinical breast exams by their healthcare providers and annual digital screening mammography after successful NA removal.

Background

Findings