Symptoms - Nipple Changes or Discharge
Breast cancer may cause changes to the nipple, including causing the nipple to face inward (inverted), causing changes to the skin on the nipple or areola (the darkened skin around the nipple), or causing discharge from the nipple. Any discharge or changes to the shape or appearance of the nipple should be discussed with a healthcare professional.1
Anatomy of the nipple
The nipple projects from the center of the areola, the darkly pigmented area in the breast. Milk ducts connect the milk glands deep in the breast to the nipple. Under the areola is a thin layer of muscle and connective tissue.2
Changes to the shape of the nipple
Some breast cancers can cause the nipple to turn inward. This is called an inverted nipple or a retracted nipple. Certain people have inverted nipples naturally – their breasts develop this way. However, if the nipple changes and turns inward, it should be checked by a doctor.3
Changes to the skin around the nipple
One rare form of breast cancer, called Paget disease of the nipple, can cause changes to the skin of the nipple and areola. The skin may appear scaly, dry, flaky, red, or crusty. The nipple and areola may have a burning or itching sensation. Paget disease can also cause nipple inversion. Any of these changes should be checked by a doctor.4
Nipple discharge
When the nipple has a discharge or fluid that comes from it, it may be different colors or textures, and it may be bloody. The discharge is different than breast milk, which naturally develops after a pregnancy.1
Most of the time, nipple discharge is due to a non-cancerous (benign) cause. However, any discharge should be brought to the attention of a doctor. The doctor will typically ask if the discharge is coming from both breasts or just one, and ask what medications the patient is taking, as some medications may cause nipple discharge. He or she will also note the color of the discharge and may order additional tests.5
Other symptoms of breast cancer
Besides changes to the nipple, breast cancers may cause other symptoms, such as6:
- A lump or area of thickened tissue in or around the breast
- Changes to the size or shape of the breast
- Changes to the skin of the breast, including a dimple or puckering
- Changes to the areola (the darker area of skin around the nipple), including scaly, red, or swollen tissue
- Multiple dimples on the skin of the breast that resembles an orange skin (peau d’orange)
Follow-up diagnosis tests
To diagnose whether changes to the breast are caused by breast cancer or another cause, several tests may be performed, including4,5: