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PubMed1977

[Benign cutaneous lymphadenosis (Bäfverstedt's disease) of the nipple (author's transl)].

Benign circumscribed cutaneous lymphadenosis of the areola of the nipple (Bäfverstedt's disease) occurs in children and adults. We observed 11 cases: 3 men, 3 children and 6 women. The areola undergoes rapid swelling and becomes red. At times the nipple itself is included. Unilateral enlargment and distortion of the nipple area becomes apparent. Sometimes this is associated with a tumor-like infiltration of the retro-mammillary tissue. In Contradistinction to Pagets disease of the nipple and to a mammillary adenoma there is no eczema and no ulceration. The clinical features and the typical pruritic course establish the diagnosis. Healing is spontaneous, but protracted. The aetiology is probably of an inflammatory nature. Treatment with short courses of antibiotics and anti-inflammatory agents resulted in a faster reduction of the cutaneous signs and corroborated the clinical diagnosis. We consider surgical treatment as unnecessary because circumscript benign lymphadenosis of the nipple area has a harmless course.

Adolescent↗

PubMed1984

Histological and ultrastructural observations of the attachment between the oral cavity of the fetus and the nipple of the mother in opossum (Didelphis azarae).

The mechanism of fixation of the fetus to the maternal nipple of opossum (Didelphis azarae) was studied in fetus of different ages through histological sections of the oral cavity keeping the nipple inside it. No organic connection was found between the maternal nipple and the tissues of the fetus. The increase of the nipple volume inside the oral cavity of the fetus and the imbrication between the corneous extracts of the nipple, palate and tongue epitheliums increase the fixation strength and contribute to the act of suckling.

Animals↗

PubMed1978

[Comparison of nipple care in the Puerperium with powder and ointment (author's transl)].

Recommendations for the care of the nipple postpartum are numerous and variable. Cracks and fissures in the nipple must be prevented to prevent mastitis. A randomized prospective study shows that it does not matter whether powder or ointments or nothing is placed on the nipples after nursing. The incidence of cracked nipples is not significantly changed by theses measures. For the prevention of mastitis the general measures for the prevention of hospital acquired infections are necessary and more important than modifications of the nipple care.

Breast↗

PubMed1994

Cytologic evaluation of nipple discharge in relation to mammary neoplasia.

Spontaneous nipple discharge as a presenting symptom was seen in 80 patients out of 3500 patients referred for cytologic examination of breast during last 5 years. Gross appearance of nipple discharge was bloody (33), serous (29), milky (16) and yellowish (2). Cytology smears showed 5 cases of carcinoma and 14 cases of intraductal papilloma. One out of two cases of male nipple discharge revealed malignant cells. Bloody nipple discharge was more often associated with carcinoma and intraductal papilloma. Hence it underscored the importance of cytologic evaluation of bloody nipple discharge.

Adult↗

PubMed1994

[Nipple-preserved mastectomy (Glt+Ax) as a standard operation for p-stage I, II breast cancer].

In this paper, surgical results of nipple-preserved mastectomy (Glt+Ax) for breast cancer were compared with those of radical mastectomy. In p-stage I breast cancer cases, survival and loco-regional disease-free rate of the nipple-preserved cases were equivalent to those of radical mastectomy group. Although nipple-preserved cases had inferiority to the radical mastectomy cases in the survival rate in p-stage II cases, loco-regional disease-free rate of nipple-preserved cases was equal to that of radical mastectomy cases. On the basis of these results, nipple-preserved mastectomy can be a standard operation of p-stage I, II breast cancer in point of the local control at least.

Adult↗

PubMed1993

[Pathology of autografts of the nipple in mammaplasty. Apropos of 2 original cases].

Autologous nipple graft is a classical technique in nipple reconstruction. The authors present two cases of deferred development of specific lesions in the grafted nipple, including one historical case of Paget's disease. After reviewing the current state of knowledge concerning Paget's disease of the nipple and in the light of these two cases, the authors discuss the histogenesis of this disease and the pathology of the grafted nipple in reconstructive surgery.

Adult↗

PubMedDate not supplied

Association of abnormal nipple aspirate cytology and mammographic pattern and density.

The pattern and density of mammograms have been shown to be associated with proliferative histopathology and an increased risk of breast cancer. We recently found that epithelial atypia in nipple aspirate fluid obtained 10-18 years earlier was associated with an increased risk of breast cancer. In the present study we examined the association between the cytology of nipple aspirate fluid and mammographic patterns in 588 volunteers recruited from the mammography clinic at the University of California. Nipple aspirate fluid cytology was classified according to the most severe epithelial change present and mammograms were classified by the Wolfe method and the percentage area of density. A direct relationship was found between mammographic density and cytological abnormality. When controlled for age, body mass index, previous biopsy, and calcification, the odds ratios of high density mammograms (over 50%) with nipple aspirate fluid cytological atypia was 4.4 (95% confidence interval, 0.9-21.5; P = 0.08) when normal cytology was the referent. These preliminary findings indicate that highly dense mammograms are associated with cytological atypia and are consistent with studies reporting an association of histological hyperplasia and atypical hyperplasia with severe mammographic findings. If confirmed by further studies, nipple aspirate cytology may be a useful adjunct to mammographic patterns in the prediction of breast cancer risk, especially among premenopausal women.

Adult↗

PubMedDate not supplied

Breast conserving surgery with nipple resection.

Breast conserving surgery with nipple resection was carried out on 4 patients with early breast cancer because location of each tumor was very close to nipple. These consisted of 3 patients with state I invasive ductal carcinoma and 1 patient with stage II invasive ductal carcinoma. Cancer cells were not recognized histopathologically in the resection margins of each case and all cases underwent a curative resection with axillary dissection (up to level III). The rested areola in each case was made to be round-shaped by skin suture and the edge of the wound located in the center of areola looked like a small nipple. The cosmetic result of this operation were excellent in all patients. This operation may be effective both for these patients with early breast cancer locating under the nipple or areola and for those whose tumor was very close to nipple.

Adult↗

PubMed1997

Erosive adenomatosis of the nipple: a benign imitator of malignant breast disease.

We present the case of a 66-year-old white woman with erosive adenomatosis of the nipple, in which an initial diagnosis of Paget's disease was considered. Diagnosis of erosive adenomatosis of the nipple was made by the characteristic histologic findings on a biopsy specimen. This essentially benign condition is generally unilateral, with erythema, crusting, and hardening of the nipple. Histologic findings of erosive adenomatosis of the nipple eliminate the diagnosis of invasive carcinoma or Paget's disease, which can have clinical features similar to those of erosive adenomatosis of the nipple.

Adenoma↗

PubMed1997

[Syringomatous tumor of the nipple. A case report and review of the literature].

The authors report a case of syringomatous tumor of the nipple in a 35-year-old woman, discovered incidentally during investigation of dysmenorrhea. After limited resection-biopsy of a cystic nipple tumor, histological results indicated the need for a partial central mastectomy with areola and nipple amputation. Although this tumor is classified as an adenoma, considered to be a benign lesion, syringomatous adenoma of the nipple is a potentially locally aggressive tumor, at risk of local recurrence and deep invasion of the mammary gland. This is a rare tumor (only 18 cases have been reported in the literature), and the histological diagnosis can be difficult, with possible confusion with a nipple duct adenoma, or tubular carcinoma.

Adult↗

PubMed1979

Radiological assessment of nipple-valve insufficienty in Kock's continent reservoir ileostomy.

In a series of 51 continent reservoir ileostomies nipple-valve insufficiency developed in 15 patients who were examined radiographically to find the cause for the loss of continency. The radiological diagnosis was confirmed at reoperation. The causes for nipple-valve insufficiency were a total or partial disappearance of the nipple-valve by sliding of the invaginate (7 cases) and dislocation of an undamaged nipple out of the reservoir (8 cases). In these groups the radiological diagnosis was compatible with the operative findings in all but one case. At reoperation a fistula in the nipple-valve was found in 3 cases, but in no instance had this been diagnosed radiologically. A correct preoperative diagnosis is valuable, especially in cases of dislocation, where a danger exists that the real mechanism of valve insufficiency may remain obscure at operation.

Humans↗

PubMed1994

Comparisons of nipple attachment and incisor growth among four species of voles (Microtus).

Patterns of nipple attachment and incisor growth were compared between four species of voles (Microtus). Offspring of two highly social species, prairie voles (M. ochrogaster) and pine voles (M. pinetorum), were shown to cling tightly to the nipples of their dams on Days 2, 6, and 10. This pattern contrasted to weak nipple attachment displayed by two less-social species, meadow voles (M. pennsylvanicus) and montane voles (M. montanus). Lengths of the upper (maxillary) and lower (mandibular) incisors of the four species were recorded throughout the first 10 days of age and in adults. Incisors of the pine and prairie voles typically erupted earlier and grew longer than those of the meadow or montane voles during the first few days of development. Incisors grew at a substantial rate in the latter two species, such that they equalled or surpassed the incisor lengths of the former two species as Day 10 and weaning approached. Patterns of incisor growth, in part, reflected those for nipple attachment, but do not appear to account substantially for differences in nipple attachment.

Animals↗

PubMed1996

Invasive Ductal Carcinoma of the Nipple: A Case Report.

We report a very rare case of breast carcinoma which possibly arose from the duct of the nipple and formed a nipple mass. A 71-year-old woman presented with an elastically hard and enlarged right nipple, 3.5x 2.8 cm in size. Mammograms and ultrasonograms suggested a benign tumor of the nipple, but histological examination revealed invasive ductal carcinoma. No Paget's cells were found in the epidermis. Modified radical mastectomy was performed. Both estrogen and progesterone receptors were positive. One of the nine axillary nodes dissected had metastatic foci. To our knowledge, this case is only the second reported case of invasive ductal carcinoma originating from the nipple. Differential diagnosis and histogenesis are discussed.

Journal Article↗

PubMed1991

Study of antireflux nipple valves of Kock ileal urinary reservoir. Experimental investigation in dogs.

To better assess the construction, maintenance, and function of the Kock ileal urinary reservoir with its continent antirefluxing nipple valves, laboratory investigations in dogs were done simultaneously with clinical trials in humans in 1983. Fifteen dogs underwent creation of hemi-Kock ileal reservoirs (without the efferent valve and limb) that were anastomosed to their bladders as enterocystoplasties. The afferent antirefluxing nipple valves were intussuscepted after 7 cm of underlying mesentery had been removed. The nipples were further stabilized with metal and absorbable (Polysorb) staples and Marlex collars. The right ureters were anastomosed to the afferent limb of the reservoirs with the contralateral systems left intact as controls. Ten dogs were able to be followed at the vivaria for twelve to thirty-six months and then studied. All nipple valves remained intact, viable, and nonrefluxing without revision. All kidneys remained histologically normal except those in dogs with dilated ureters secondary to ureteroileal stenosis with concurrent calculi formation. Calculi formed on exposed metal staples and Marlex. The absorbable staples were found to promote appropriate healing and were never the nidus for stone formation. It appears that the intussuscepted nipple valve (with its mesentery removed) is reproducible and functionally reliable in preventing reflux. It also appears these valves can histologically preserve diverted kidneys if the upper urinary tract drainage is normal and calculi are minimized. The proper placement of staples and the elimination of Marlex-anchoring collars are indicated to minimize calculi.

Anastomosis, Surgical↗

PubMed1990

A new technique for ileal nipple fixation: preliminary report.

A new technique for ileal nipple fixation is described in 6 post-cystectomy patients (4 with an ileal bladder substitute and 2 with an ileal reservoir) for the prevention of reflux. Nipple formation is helped by deperitonealization and defatting of the nipple mesentery. A full circumferential incision is made, except for the mesenteric border, and through both nipple layers down to the mucosa of the inner layer. The seromuscular layers on each side of the incision are closed together with continuous 3-zero polyglycolic acid suture. The overlying outer mucosa of both edges then is closed. Endoscopic and radiographic study 6 to 12 months postoperatively showed a stable nipple without reflux. The anatomical and physiological rationale of the technique is discussed.

Humans↗

PubMed1971

Florid papillomatosis (adenoma) and other benign tumours of the nipple and areola.

The paper deals with 20 benign tumours of the nipple and areola. The most common lesion was adenoma or florid papillomatosis (11 cases). On the basis of clinical and histological differences, the cases were divided into two groups.Group I.-Tumours showing an adenomatous pattern (5 cases) appropriately termed adenoma of the nipple. Chief clinical features were younger age, long duration and enlargement of the nipple as a predominant symptom. Histological characteristics were elongated tubules separated by a varying amount of fibrous stroma and squamous metaplasia in some of the cases.Group II.-Tumours showing a papillomatous pattern (6 cases) appropriately designated as florid papillomatosis. Clinically, the patients were older. Chief complaint was bleeding from the nipple of a few months' duration. Histologically, dilated lactiferous ducts were seen filled with papillary, cribriform and solid growth of cells. Other features such as apocrine metaplasia, foam cells and central necrosis were observed.The interpretation of this grouping is discussed.A case of adenoma of an accessory nipple is reported.Other benign tumours observed were five papillomas, one leiomyoma, one haemangioma, one fibroma and one lipoma.

Adenoma↗

PubMed1999

Reduction of potential contamination of breast implants by the use of 'nipple shields'.

Forty-three breast implant operations in 25 patients were studied prospectively to determine the effectiveness of covering the nipple-areolar complex with an adhesive film dressing in preventing perioperative expression of bacteria from nipple ducts contaminating the operative field. One swab from the nipple after skin preparation and none of the swabs taken from the outer surface of the film dressing postoperatively yielded any bacterial growth. Fourteen breasts (33%) in 11 patients (44%) yielded bacterial growth from swabs under the film postoperatively. Six of 9 breasts (67%) in 5 patients who had capsulectomies had bacteria isolated from under the film postoperatively. Ten of 14 (71%) control breasts (no shields) in 6 of 7 patients (86%) had positive postoperative swabs. This study confirms the potential risk of bacterial contamination arising from nipple duct flora during intra-operative breast manipulation, and the effectiveness of a perioperative adhesive film placed over the nipple-areolar complex in preventing subclinical bacterial contamination of implanted breast prostheses.

Bacteria↗

PubMed1982

[Bowen's disease of the nipple].

The clinical and morphological features of Bowen's disease of the nipple are reported. The 51 year old patient had an eczema type change of the left nipple for over 1 year. The microscopic evaluation of the extensive segmental resection showed Bowen's disease of the nipple. Paget's disease was excluded with certainty. As far as the authors know this is the first case of Bowen's disease of the nipple reported. The treatment of choice is extended segmental resection. With this treatment the prognosis of Bowen's disease of the nipple appears to be favourable.

Bowen's Disease↗