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PubMed1990

A behavioral bioassay for analysis of rabbit nipple-search pheromone.

To suckle, newborn rabbits are completely dependent on a pheromone present on the doe's ventrum and also apparently contained in the milk. Pups presented in a standardized test with 30 microliters of fresh rabbit milk on a glass rod reacted with vigorous search-like movements in 93%, and with grasping of the rod in 70% of trials, but did not respond to control presentations of other odorants. The pups were found to be most reactive 1-3 hours before the once daily nursing, and although they rapidly habituated to repeated testing, a break of 30 minutes was sufficient for the recovery of responsiveness. Even milk diluted by as much as 1:10(4) elicited significantly more responses than control substances. However, when left at room temperature it lost this behavior-releasing quality within about 20 minutes, but retained it for several months when stored at -40 degrees C. Rabbit milk thus appears to represent a ready source of nipple-search pheromone, and the behavioral response of pups to be reliable enough to serve as a bioassay for further pheromonal analysis.

Aging↗
PubMed1987

Brain serotonin depletion and nipple attachment in rat pups.

5,7-DHT (104 micrograms) was injected into the third brain ventricle of three-day-old rat pups 1 hr after desmethylimipramine pretreatment (20 mg/kg IP). Whole-brain serotonin was depleted by 50%, and there was some retardation of weight gain. Nipple attachment was observed in sucklings and in weaned pups. When 9 days old, attachment in 5-HT depleted pups was delayed and they were less active when undeprived, but not when 8 hr deprived. In comparison with pups raised in litters of 6 or 14, which served to control for reduced body weight, depleted pups' behavior was more similar to the heavier pups, suggesting that the behavioral differences were not due to retarded growth. After weaning at 21 days, depleted pups attached more up to 37 days of age, after which attachment was not reinstated by treatment with methysergide, suggesting that the waning of depletion induced attachment was not due to recovery of serotonergic function. Again, body weight controls showed that the effects were not due to retarded weight gain in the depleted pups. The results confirm the biphasic action of 5-HT antagonism on attachment, i.e., inhibition in the neonate and disinhibition in the weanling. The findings also show that central 5-HT systems are involved in the inhibition of attachment during weaning, but that this involvement is transient, and apparently not crucial.

5,7-Dihydroxytryptamine↗
PubMed1987

Supernumerary nipples and urologic malignancies.

The prevalence of five minor malformations and three palmar or finger crease abnormalities was determined in a total of 203 patients with urologic malignancies. An equal number of control individuals with acute infections or cardiopulmonary complaints was matched consecutively to the patients by sex and age. A significantly higher frequency of supernumerary nipples was found in all types of urologic tumors examined: the total prevalence was 32 of 203 in the patients, and four of 203 in the controls (p less than 0.001). Bifid uvula, preauricular pits, and abnormal palmar creases were also slightly more common in the patients, but the differences were not statistically significant.

Adult↗
PubMed1990

Basal cell carcinoma of the nipple. Report of two cases.

Two cases of basal cell carcinoma of the nipple are presented, bringing the total number of reported cases to 15. The majority, including our two patients, are elderly men. This finding suggests a causal role of exposure to ultraviolet radiation. In our cases excision was curative.

Aged↗
PubMed1995

Superficial papillary adenomatosis of the nipple: a case report and review of the literature.

Superficial papillary adenomatosis of the nipple is a benign tumor of the ductal epithelium that clinically resembles Paget's disease. Histologically, the tumor is characterized by proliferating ductal structures lined by a double layer of columnar epithelium. Keratin cysts and apical intraluminal projections are commonly found. Since this entity's original description as "florid papillomatosis" in 1954, 174 cases have been reported in the English language literature. We review these cases and report a classic example.

Adenoma↗
PubMed1980

The nipple-shield sampling system: a device for measuring the dietary intake of breast-fed infants.

We have devised a method for the determination of the composition of the milk infants obtain from the breast during suckling itself, suckled breast milk (SBM). The method involves the use of a nipple-shield sampling system, together with data on the pattern of milk flow from mother to infant derived from a cross-sectional analysis of test weighings during feeding. In this study, marked changes were demonstrated in milk fat the sixth day postpartum. From this information the total intake of fat and energy during the feed was calculated. These preliminary findings suggest that published information on the dietary intake of breast-fed infants may need some revision.

Breast Feeding↗
PubMed2004

Patient and duct selection for nipple duct lavage.

BACKGROUND: Nipple ductal lavage (NDL) is a new minimally invasive procedure with the potential to help identify women who could benefit from breast cancer risk intervention. NDL is currently encouraged for women with fluid-producing ducts and a 5-year Gail risk > or =1.7%. The purpose of this study was to evaluate the atypia rate by NDL in fluid-producing ducts compared with non-fluid-producing ducts and the atypia rate in high-risk verses low-risk patients to determine if current recommendations are supported. METHODS: Fifty-nine women were studied with NDL. The 226 ducts lavaged included all fluid-producing ducts (n = 136) and any dry ducts we could cannulate (n = 90). Breast cancer risk was calculated using mathematic models. RESULTS: There were 26 (44%) women with a 5-year Gail risk > or =1.7% and 33 (56%) with a 5-year Gail risk <1.7%. Cytologic atypia was diagnosed in 20 of 59 (34%) of patients. The atypia rate was similar for women with a 5-year Gail risk > or =1.7% (9 of 26 or 35%) compared with lower-risk women (11 of 33 or 33%, P = 1.0) and for fluid-producing ducts (26 of 136 or 19%) compared with dry ducts (14 of 90 or 15%, P = 0.61). No significant differences were found when the atypia was categorized as mild versus marked. Of note, the insufficient sample rate was higher for dry ducts (33%) compared with fluid-producing duct (22%, P = 0.07). CONCLUSIONS: If NDL results are found to correlate with breast cancer incidence, it will be important to apply the test in a way that maximizes sensitivity for the detection of atypia in a screened population. We were unable to identify patient or duct characteristics that predict NDL atypia rates.

Adult↗
PubMed2005

The value of clinical characteristics and breast-imaging studies in predicting a histopathologic diagnosis of cancer or high-risk lesion in patients with spontaneous nipple discharge.

BACKGROUND: The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). METHODS: The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 were reviewed. The sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of mammogram, ultrasound, and ductogram in predicting high-risk lesions and cancer were calculated. RESULTS: The sensitivity of mammography was 10%, the specificity 94%, the NPV 88%, and the PPV 18%. Ultrasonography had a sensitivity of 36%, specificity of 68%, PPV of 14%, and NPV of 89%. Ductography had a sensitivity of 75%, specificity of 49%, and NPV and PPV of 93% and 18%, respectively. CONCLUSIONS: Conventional imaging studies do not accurately identify cancer or high-risk lesions in patients with SSND. All patients with SSND should be offered duct excision.

Adult↗
PubMed2006

Correlation of nipple aspiration and ductal lavage cytology with histopathologic findings for patients before scheduled breast biopsy examination.

BACKGROUND: The use of ductal lavage to obtain cells from within the breast ducts has been described for patients at high risk for breast cancer. The purpose of this study was to correlate ductal lavage cytologic findings with the corresponding histology. METHODS: Twenty-two patients were evaluated and 20 patients underwent ductal lavage followed by breast biopsy examination as a result of positive nipple aspiration fluid. Ductal lavage samples were classified by a cytopathologist as negative, mild atypia, marked atypia, or malignant. A different pathologist interpreted the histologic findings of the biopsy examination. RESULTS: Adequate specimens for cellularity were obtained in 12 of 22 (53%) patients: 6 of the 12 (50%) had both benign cytology and histology, 2 (16.7%) had benign cytology with atypical ductal hyperplasia or atypical lobular hyperplasia on histology, 2 (16.7%) had marked atypia on cytology and benign histology, and 2 (16.7%) had malignant cytology and benign histology. The specificity of the procedure was 83.4%. CONCLUSIONS: Ductal lavage yielding an adequate sample for analysis was successful in only 52% of patients. Of those, the cytologic-histologic correlation was discordant in 50%. The role of ductal lavage in accurately predicting lesions present on subsequent breast histologic evaluation of planned biopsy examinations requires further investigation.

Adult↗
PubMed2006

The patient's experience of a nurse-led nipple tattoo service: a successful program in Warwickshire.

INTRODUCTION AND AIMS: Although once the preserve of tattoo artists, units within the UK have increasingly begun making use of the Clinical Nurse Specialist (CNS) to perform areola tattooing. Bringing the technique within the Breast Unit enhances continuity of care and makes use of skills that can be provided by the CNS. Our CNS is involved with both the patients' oncological management and the areola tattoo service. MATERIALS AND METHODS: The CNS-led service was investigated and patients' experiences of nipple tattooing were assessed. We present the results of a postal questionnaire and a prospective clinical audit of the procedure. RESULTS: Forty tattoos were done over a 2-year period with one self-limiting complication. Patient satisfaction was high both with the outcome and the experience of the procedure. Fading of the tattoo is a consistent finding frequently requiring further shading. CONCLUSION: Overall the patient's experience of a nurse lead 'in-house' tattoo service has been highly satisfactory and this is reflected by their high confidence rating and ease of access to the nurse. We believe that the role of the CNS in oncological treatment and reconstructions helps integrate the multidisciplinary experience for the patient.

Color↗
PubMed2006

Tattooing of the nipple-areola complex: review of outcome in 40 patients.

Reconstruction of a pigmented nipple-areola complex (NAC) is one of the final steps in rehabilitating patients following mastectomy. We report the results of 40 consecutive patients who had NAC tattooing done by the same surgeon. Assessments were made both subjectively using a questionnaire, and objectively by using a computer software programme (Adobe Photoshop) to analyse the colour of the NACs. Follow up ranged between six and 24 months (mean 14 months). One patient suffered an infection, and was the only one to need repeat tattooing in our series. Thirty-seven patients (92%) reported some colour fading which ranged between 5% and 80% (mean 32%). A grade of good or very good was given by 33 patients (82%) for colour match, by 36 patients (90%) for over all satisfaction, and by 34 patients (85%) for enhancement in body image. An analysis of the colours of the tattooed and unoperated NACs by the software programme showed that they were similar to a value that ranged from 78% to 97% (mean 91%). Tattooing is a simple and safe procedure, and despite some colour asymmetry it still has a high satisfaction rate. It significantly improves patient's perception of body image. An objective assessment of tattooing using a computer software programme can be a useful tool in reviewing the outcome. Video clips (1-5) are included with the paper for demonstration of the tattooing technique (re-arranged from the video presented with the paper at BAPS).

Adult↗
PubMed2005

Cytomorphology as a risk predictor: experience with fine needle aspiration biopsy, nipple fluid aspiration, and ductal lavage.

Primary prevention of breast cancer requires identification and elimination of cancer-causing agents, which is an incredibly difficult task to follow. Secondary prevention involves screening individuals who are at increased risk for breast cancer in hopes that early intervention will affect survival. In the 1980s, chemoprevention received serious attention. This approach was aimed at reducing cancer risk by administration of natural or synthetic clinical compounds that prevent, reverse, or suppress carcinogenesis in individuals at increased risk for cancer. It was not until 1998, however, when the first report from the National Surgical Adjunct Breast and Bowel Project (Breast Cancer Prevention Trial BCPT; P-1) randomized clinical trial appeared in the literature supporting the hypothesis that breast can-cer can be prevented. This study showed that administration of tamoxifen reduced the risk for invasive and noninvasive breast cancer by almost 50% in all age groups. With the current availability of tamoxifen as a chemopreventive agent and with the increasing emphasis on early breast cancer detection and prevention, more women seek consultation to determine their risk for breast cancer. However, in the absence of any detectable breast lesion, clinically and mammographically, only a few women may volunteer to have their breasts sampled by surgical biopsy for risk assessment. Other non-surgical procedures include fine needle aspiration biopsy (FNAB), nipple aspirate fluid (NAF), and the recently introduced procedure, ductal lavage. These techniques may provide better alternatives. These minimally invasive procedures are capable of recruiting cellular material for cytomorphologic interpretation and biomarker studies.

Biopsy, Fine-Needle↗
PubMed2006

Some fibrocystic breast change may be caused by sexually transmitted H. pylori during oral nipple contact: supporting literature and case report of resolution after gut H. pylori eradication treatment.

OBJECTIVES: To briefly review previously published evidence for Helicobacter pylori (Hp), colonization of extra-intestinal sites and suggest an hypothesis that breast acini and ducts be added to this list, concluding such breast colonization is not rare and is a sexually transmitted infection. METHODS: PubMed literature search and review with a case report. CONCLUSIONS: (1) Evidence indicates oral Hp is common and can remain in the mouth after successful eradication in stomach and duodenum. (2) Evidence indicates that the breast is also occasionally colonized by Hp. (3) Hp may be injected retrograde up into ducts of the breast during oral nipple stimulation during sexual activity and this Hp may give rise to some cases of fibrocystic breast change. (4) A case of painful fibrocystic change that had been present for two years in a 27 year old female, resolved after gastrointestinal Hp treatment.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2004

The association of bloody nipple discharge with breast pathology.

BACKGROUND: It is believed that bloody spontaneous nipple discharge (SND) portends a greater chance of malignancy than nonbloody discharge, and that cytologic evaluation of SND assists in treatment planning. Our aims were to assess (1) the pathology of women with/without SND who require diagnostic breast surgery, (2) whether bloody SND is associated with a different spectrum of pathologic findings than nonbloody, and (3) whether SND cytology is influenced by pathologic findings. METHODS: One hundred seventy-five women who underwent breast operation were enrolled. Cytologic evaluation was performed on Papanicolaou-stained cytospin preparations of SND. RESULTS: Papilloma and hyperplasia (both without atypia) were more frequent in breasts with than without SND; breast cancer was more common in breasts without SND (P <.001 for all). All cases of breast cancer with SND, but only 33% without, contained a papilloma or papillary features. Seventy-five percent of cancers presenting with SND were nonbloody. Papilloma was the most common diagnosis in breasts with bloody SND and was more common (P=.017) than in breasts without, whereas hyperplasia was the most common diagnosis in breasts with nonbloody SND and was more common (P=.031) than in breasts with bloody SND. SND cytology was not significantly influenced by pathology. CONCLUSIONS: Breast cancer can present as unilateral nonbloody SND, indicating the importance of surgical intervention. Papilloma was more common in women with SND than without and most often presented as bloody SND.

Adult↗
PubMed2000

Supernumerary nipple as a cutaneous marker of mitral valve prolapse in Asian Indians.

We studied 68 Asian Indians from South India with supernumerary nipple (SN) and 49 age- and sex- matched controls without SN for evidence of mitral valve prolapse (MVP) and associated features. We found that MVP and its forme fruste were more common in the SN group (odds ratio 6.0, 95% confidence intervals 2.16 to 16.63), indicating an association of SN with MVP.

Adolescent↗
PubMed2001

Endocarditis after nipple piercing in a patient with a bicuspid aortic valve.

Piercing the skin for cosmetic reasons can be dangerous in young adults who have previously undergone surgery for congenital defects of the heart. We report the case of a 24-year-old man in whom coarctation of the aorta had been corrected 15 years earlier. Two months after piercing his left nipple without antibiotic prophylaxis, he developed a local mastitis, followed by bacterial endocarditits that required replacement of the aortic valve.

Adult↗
PubMed1996

Nipple reduction with a modified circumcision technique.

Several methods of reduction of the hypertrophic nipple have been reported. All of them have some drawbacks. We propose a technique that can be easily performed and can produce excellent aesthetic as well as good functional results.

Adult↗