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At least 775 records · Page 43Linked to original sources
PubMed1996

Long-term nipple shield use--a positive perspective.

This report describes ten cases in which silicone nipple shields were used for two weeks or longer. In nine of the cases, shields were used to help babies attach to the breast. These babies had struggled to attach to the areola because of suck problems or the mother's lack of protractility of breast tissue. In the tenth case, the shield was used because of extreme nipple soreness. All babies were off the shield by 3.5 months of age; nine were feeding directly from the breast. All weights were appropriate or above for the age of the infant at three weeks, two months and four months.

Breast Feeding↗
PubMed1996

Transitioning to the breast at six weeks: use of a nipple shield.

After forceful help with breastfeeding on the first day after birth, a baby began to refuse to latch onto the breast. The mother received help maintaining her milk supply and advice on feeding methods and use of a nipple shield from a lactation consultant after leaving the hospital and was eventually able to breastfeed with the help of a nipple shield. Important aspects of this case were the treatment in the hospital, which included forcing the baby to the breast and using a tube-feeding device with artificial baby milk. Also critical was this mother's commitment to breastfeeding and the long-term support she received.

Bottle Feeding↗
PubMed2006

Fibrous Histiocytoma-like Spindle-Cell Proliferation in the Nipple After Body-Piercing.

We report the case of a 19-year-old pregnant woman who presented with a nipple tumor. The lesion consisted in a spindle-cell proliferation with histologic features similar to those of fibrous histiocytoma, with a highly vascularized stroma. Although it showed low mitotic activity, scattered marked atypical cells with prominent nucleoli were identified, thus raising concern about the benign nature of the tumor. Immunohistochemical evaluation revealed that the spindle cells were diffusely positive for vimentin, focally positive for CD68, and negative for all the other tested antibodies. The patient had a total excision of the lesion and she is free of disease after 30 months. To our knowledge this is the first reported case of a lesion of this type in the nipple after body-piercing.

Adult↗
PubMed2005

Pathologic nipple discharge: surgery is imperative in postmenopausal women.

BACKGROUND: A total of 10% to 15% of pathologic nipple discharge in women is due to malignant lesions of the breast. The purpose of this study was to discover the rate of breast cancer in women who present with this symptom and undergo ductal excision, to evaluate the different diagnostic methods used before surgery, and to discover whether there are specific factors with regard to dignity. METHODS: We analyzed 118 ductal excisions in 116 patients performed at the women's hospital of the University of Rostock, Germany, between 1995 and 2002. The discharging duct was identified by preoperative galactography. RESULTS: The rate of cancer in these patients was 9.3% (n = 11). The most frequent benign lesion was intraductal papillomatous proliferation (36.4%; n = 43). Solitary papillomas were shown in 21.2% (n = 25), and other specific benign histologic findings were shown in 27.1% (n = 32). Women with malignancies were significantly older (P = .009) and were more often postmenopausal (P = .095) compared with patients with benign histology. Galactography was the method that reached the highest sensitivity (73%), and clinical examination showed the highest specificity (85%) in distinguishing between benign and malignant lesions. CONCLUSIONS: Because 94.1% of all cases presented with specific histological findings causing pathologic nipple discharge, ductal excision combined with preoperative galactography was proven to be a sufficient method for diagnosis and therapy. This procedure should be performed in all postmenopausal women with this symptom because of a cancer rate of 12.7% among this age group and the unsatisfactory quality of other diagnostic methods.

Adult↗
PubMed2000

Predictive value of galactographic patterns for benign and malignant neoplasms of the breast in patients with nipple discharge.

The purpose was to identify features of malignant and non-malignant neoplastic breast disease on galactography and to estimate their predictive value. This is the largest reported study correlating galactographic morphological patterns with histopathology and the only blinded study. The study included 351 consecutive galactograms and 161 breast biopsies performed in patients with nipple discharge over a 10-year period. Three radiologists, blinded to clinical data and histological results, re-evaluated 158 previously performed galactograms of patients who had undergone excision biopsy. Extravasation or incomplete filling precluded reading in 9.5% of examinations. Among the remaining 143 examinations there were 11 cancers (7.7%), 56 papillomas (39.2%), 19 cases of intraductal papillomatous proliferation (13.3%), 55 cases of fibrocystic or secretory disease (38.5%) and two normals. A "filling defect/cut-off" pattern (n = 90) was found in 6 cancers (6.7%) and 58 cases of papilloma or papillomatous proliferation (64.4%). A "leafless tree" pattern was found only in benign cases (n = 12; 8.4%). In 32 of 143 cases (22.4%) a "ductal ectasia" pattern was present, in one case of which (3.1%) cancer was found. Cancer was identified in two of four cases with an "architectural distortion" pattern. Cancer is rare in patients with nipple discharge. A tendency towards a lower incidence of cancer associated with the "ductal ectasia" and "leafless tree" patterns was found. No statistical evidence was found to indicate that galactography provides an effective prospective diagnosis of malignancy. However, an abnormal galactogram strongly correlated (p < 0.001) with the presence of a breast neoplasm when both benign and malignant tumours were considered. The most important role played by galactography is in the localization of breast neoplasms and in the choice of appropriate surgical therapy.

Adult↗
PubMed2004

Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple-areolar complex.

MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple-areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.

Aged↗
PubMed2006

Bloody nipple discharge in an infant and a proposed diagnostic approach.

Bloody nipple discharge is a rare finding in infants and is associated most often with benign mammary duct ectasia. The rarity of this symptom in infants and its association with breast carcinoma in adults can lead to unnecessary investigation and treatment. Here we describe a 4-month-old boy with bilateral bloody nipple discharge that resolved spontaneously without treatment by 6 months of age. Furthermore, we propose a strategic method for the evaluation of such infants.

Blood↗
PubMedDate not supplied

Unilateral nevoid hyperkeratosis of the nipple: a report of two cases.

Nevoid hyperkeratosis of the nipple and areola is an unusual condition. Two female patients aged 31 and 18 years presented with chronic unilateral warty lesions of the nipple. One patient had difficulty in breastfeeding from the affected side. A skin biopsy showed acanthosis, hyperkeratosis, papillomatosis and lymphocytic infiltrate in the dermis. There was no significant improvement with topical tretinoin cream in both the patients.

Adolescent↗
PubMed2004

Primary basal cell carcinoma of the nipple.

Basal cell carcinoma arising from the nipple of the breast is an uncommon malignancy, with only a handful of cases reported in the literature. The diagnosis is, however, important because basal cell carcinoma in this location can mimic breast cancer, may behave aggressively, and there is a relative lack of consensus in its treatment. A case of basal cell carcinoma of the nipple is described in a 67-year-old man with a brief review of the literature.

Aged↗
PubMed2000

[Infiltrating syringoadenoma of the nipple: a new case].

Infiltrating syringomatous adenoma of the nipple is composed of small sweat ducts and solid strands, surrounded by desmoplastic stroma and preferentially develops in the superficial breast tissue and specially in the nipple. This particular and exceptional lesion deserves to be acknowlegded by pathologists concerned with breast pathology since this tumor mimics grade 1 invasive breast ductal carcinoma.

Breast Neoplasms↗
PubMed2000

A simple approach to nipple discharge.

Evaluation and management of patients with nipple discharge (ND) aims to identify carcinoma when present, and in benign cases, stop the discharge when bothersome. We reviewed our recent experience with ND to develop a simple and effective algorithm to manage these patients. Records of all patients with ND evaluated from December 1996 through June 1999 were reviewed. Patients were liberally offered duct excision for a clinical suspicion of malignancy (persistent clear or bloody fluid) or to stop bothersome discharge. Patients with breast imaging abnormalities (mammography or ultrasound) related to their ND underwent biopsy and were considered separately. Of 104 patients with ND, 11 underwent biopsy as a result of mammographic findings; three of these cases proved malignant. The remaining 93 patients were evaluated with 55 tests that did not demonstrate malignancy, including ductography, discharge fluid cytology, serum prolactin and thyroid-stimulating hormone levels, and image-guided breast or nipple biopsy. Thirty-nine patients underwent duct excision with only a single patient demonstrating malignancy. Clinical follow-up has not identified malignancy in any patient managed nonoperatively. When diagnostic breast imaging is negative, malignancy related to ND is uncommon. Patients with ND should have diagnostic breast imaging and, if it is negative, should be offered duct excision. There is little role for ductography, cytology, or laboratory studies in evaluating these patients.

Adult↗
PubMed1975

[Nipple discharges without palpable tumor].

In the majority of the cases of nipple discharge the cause is a benign lesion: nearly 50% are papillomas. Biopsy is always indicated in nipple discharge without palpable tumor. A long follow-up of the patients is necessary.

Biopsy↗
PubMedDate not supplied

[Leiomyoma of the nipple].

A case of 28 years woman with nipple's leiomyoma we report. Only 38 cases are reported in the literature. This neoplasm presents a difficult differential diagnosis with the remaining flogistic and neoplasm breast and nipple disease.

Adult↗
PubMedDate not supplied

[Banana peel: a possible source of infection in the treatment of nipple fissures].

OBJECTIVE: To study the microbiology of banana peel being sold in the city of Rio de Janeiro, in an attempt to determine the possibility that the peel may represent a source of infection for women who use it to treat nipple fissures. METHODS: The following microorganisms were studied in 20 banana peel samples: mesophiles, total coliforms, fecal coliforms, Pseudomonas aeruginosa, lipolytic and proteolytic microorganisms, molds and yeasts, lactic bacteria, and coagulase-positive staphylococcus. RESULTS: The microbiological analyses revealed the occurrence of several typical groups of microorganisms, with the following distribution of positive results being detected in banana peel samples: mesophiles, 100%; total coliforms, 20%; coagulase-positive staphylococcus, 25%; molds and yeasts, 30%; proteolytic microorganisms, 70%; lipolytic microorganisms, 30%, and lactic bacteria, 95%. Fecal coliforms and Pseudomonas aeruginosa were not isolated. CONCLUSION: The results show the presence of potentially pathogenic microorganisms in levels which could compromise the microbiological quality of the banana peel. Its use for the treatment of nipple fissures can initiate an infectious process.

Breast Diseases↗
PubMedDate not supplied

Mastitis nonpuerperalis after nipple piercing: time to act.

OBJECTIVE: To review the literature and discuss problems related to post-piercing breast abscesses. MATERIALS AND METHODS: Retrospective analysis of 10 case reports after Medline and internet search regarding breast abscess after nipple piercing. RESULTS: Nine case reports are published in Medline so far, the first in 1982, but eight within the last 3 years. One abstract of a case report presented at a meeting was found on the internet. Average patient age was 31.2 (15-60) years; 7 female and 3 male. Side of breast infection was 5 right, 4 left, and one both. The interval between piercing and treatment was on the average 20.8 (2-52) weeks, duration of symptoms 1 week to several months. Therapy in 9 patients was antibiotics and in 7 operation. The following major complications were seen: endocarditis, heart valve operation, prosthesis infection, metal foreign body in breast tissue, one reoperation because of recurrent infection, psychological stress because of primary diagnosis of breast cancer in 2 cases. CONCLUSION: The risks in nipple piercing are obviously under-documented and may be as high as 10-20% in the months after the procedure. Healing of the wound channel can take 6-12 months.

Abscess↗
PubMed2004

[Modified radical operation for early breast cancer for preserving nipple-areolar complex and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap].

BACKGROUND & OBJECTIVE: Modified radical mastectomy (MRM) operation has become an important surgical therapy for early stage breast cancer, but how to reconstruct breast and preserve nipple-areolar complex (NAC) is controversial. In this study, we applied a modified radical mastectomy for early stage breast cancer for preserving NAC and breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap. METHODS: During operation we performed the subcutaneous glandular excision and axillary dissection, and reconstructed the breast using TRAM flap in 10 patients with early stage breast cancer; meanwhile, maximam extent of breast skin and NAC were preserved. RESULTS: The appearance of the reconstructed breast was better preserved after operation. No local recurrence and distant metastasis occurred in the patients during the follow up time (range 24-48 months). No skin flap necrosis, atrophy, and scleroses surround the NAC were observed; and no abdominal wall hernia occurred at the donor site. The nipple sensation was recovered half a year after surgery. CONCLUSION: Modified radical operation for preserving NAC and breast reconstruction using TRAM flap may be a better way for breast cancer patients in early stage who request well preserving of breast. More samples are needed for proving the effects of this operation.

Adult↗
PubMed2003

The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples.

In recognition of the irrefutable disadvantages of not breastfeeding to the mother, baby, society and the environment, increasing the duration of breastfeeding has become a focus of national and international health objectives. However, many mothers experience such painful sore nipples that they stop breastfeeding before they intended. The purpose of this study is to examine the relationship between various aspects of optimal breastfeeding (e.g. the positioning of the baby at the mother's breast, the positioning of the baby's head and mouth, the breastfeeding dynamic and the latching process) using a guided assessment and documentation tool and the breastfeeding mother's level of reported pain on a five-point verbal descriptor scale. Ninety-five healthy postpartum breastfeeding mothers who sequentially reported sore nipples within ten days of giving birth to healthy, term babies in a hospital in Latvia participated in the study. Each mother's midwife observed, assessed and documented a breastfeed using a guidance assessment form, the Lactation Assessment Tool (LAT). Each mother scored her own pain during breastfeeding. Four attribute categories were scored and examined as related to the pain levels of the mother: the baby's face position (chin and nose and head position, cheekline, lip flange and angle of mouth opening); the baby's body position (height at the breast, body rotation and body in relation to mother's body); the breastfeeding dynamic (change in breastfeeding pattern (suck vs swallow) and movement of mother's breast) and the latching process of the baby (root, gape, seal and suck). No significant difference was found between the mother's level of reported pain and the assessed head position, body position or breastfeeding dynamic attributes of the baby. However, more optimal latching process behaviour of the baby (rooting, gaping, sealing, and sucking behaviour) are slightly related to lower levels of reported pain (r(88) = -0.09, p > 0.05). This should serve to remind clinicians that no one aspect of positioning may be more critical than another. Assessment of breastfeeding should be comprehensive and should begin before the infant is at the breast. Early stages of the infant's breast seeking behaviours should be observed as well as the actual feeding.

Adult↗