Adenoma of the nipple.
Among the diseases of the breast, adenoma of the nipple is an uncommon lesion. This case report describes the clinical data and radiological signs. A literature review of the histopathology is given.
Aged↗
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Contraction stress test by intermittent nipple stimulation.
Although the nonstress test has generally supplanted the contraction stress test as the primary test for assessment of fetal well-being, the contraction stress test continues to be useful. Objectionable factors of the contraction stress test have included the time required to complete the test and the frequent necessity for intravenous oxytocin. The authors developed a contraction stress test protocol using contractions produced by intermittent nipple stimulation and used the method for 345 tests on 193 high-risk pregnancies during a 15-month period. The women were instructed to stimulate one breast, through their clothes, for two minutes and then to rest for five minutes. This cycle was repeated as necessary, but was interrupted whenever contractions began. Using this protocol, the authors were successful in achieving an adequate contraction frequency with every attempt, and hyperstimulation was not more frequent than previously reported with the standard contraction stress test. The average time requirement was 45 minutes. No unexplained stillbirths occurred after a negative test.
Breast↗
[Lymphocytic infiltrations of the nipple. The benign cutaneous lymphocytoma of the breast areola (author's transl)].
Benign lymphocytic infiltrations may often occur in the skin of nipple and areola: 55 cases have been described in literature especially in Scandinavia and in Germany, sometimes in correlation with tick bites or erythema chronicum migrans, but until now no cases have been reported in France. In a retrospective study of 30 cutaneous lymphocytomas, we found 8 cases localized on the breast-3 children and 5 older patients-, associated with a erythema chronicum migrans in 3 patients and following a tick bite in another patient. The course of the disease is always benign and the healing can be accelerated by penicillin therapy. The pathogenesis still remains unclear but some data argue for an infectious mechanism: frequency of tick bites (20 p. 10), geographical occurrence in the spreading area of common ticks in Europe, affinity of ticks for the breast in all mammals, carriage of viruses by some tick species, efficiency of penicillin in tick-transmitted viral infectious and in benign skin lymphocytomas, positive inoculations in volunteers, general course of an infectious disease (seasonal variations, frequency of satellite lymph-node swelling, spontaneous healing).
Aged↗
Centrifugal cytology of nipple aspirate cells.
Two improvements in the methodology for obtaining and preparing nipple aspirates from nonlactating women are reported. The first is the development and use of a new breast pump with a controllable vacuum and cups of various sizes. The second is the use of centrifugal cytology to prepare the dispersions. Twenty-one of 24 breasts of patients in the age range 30 to 49 years produced cellular dispersions which contained foam cells; of them, 13 contained ductal cells. A comparison of glutaraldehyde and ethanol fixation indicated that the cells appeared substantially the same.
Adult↗
Cytologic studies of nipple discharges.
Cytologic findings of nipple discharges from 71 histologically confirmed breast cases (29 malignant and 42 benign) were analyzed. Papillary clusters composed of more than 30 ductal cells were found in the discharges from 18 of the malignant cases (62%) and 6 of the benign cases (14%); all 6 benign cases with papillary clusters were papillomas. Erythrocytes were detected in the discharges from 15 of the malignant cases (52%) and 5 of the benign cases (12%); 4 of the 5 benign cases with bloody discharge were papillomas. Both erythrocytes and papillary clusters were observed in the discharges from 14 of the malignant cases (48%) and 2 of the benign cases (5%).
Breast↗
Clinical significance of recent inversion of the nipple: a reappraisal.
In a retrospective survey of 63 cases of inverted nipple, unaccompanied by a palpable mass, 3 histologically confirmed carcinomas were found on combined clinical and mammographic examination - an incidence of 5%. No carcinoma was found in those patients under 50 years of age. The problem of the false negative mammogram is discussed.
Adult↗
[The inferior pedicled nipple-cutis fatty flap in cases of mammoplasty].
The problem connected with reduction-mammoplasty consists of preserving a sufficient circulation of nipple and areola. A pedicled cutis fatty flap in the direction of the submammary fold prevents this complication. The surgical technique is described in detail. This pedicled flap is also in use for subcutaneous mastectomy in cases of macromastia with a surplus of skin to be removed. The pedicled flap prevents the dislocation or turning of the silicone-prosthesis.
Breast↗
Curiosa paediatrica V: Inverted nipples.
Inverted, retracted or indrawn nipples are established in very early infancy, perhaps even prenatally, and are to be regarded as a developmental mammary malformation which is not corrigible by any manipulation. This fact should be recognized by parents and by antenatal supervisors who are consulted or called upon to advise about breast-feeding.
Breast↗
Reconstruction of the nipple-areola by dermabrasion in a black patient.
Dermabrasion of breast skin resulted in a hyperpigmented area creating a nipple-areola complex in a black patient without the need for a skin graft. Satisfactory hyperpigmentation in patients with light skin might occur with ultraviolet light supplementation.
Adult↗
Factitious pseudoainhum of the nipple.
A patient with a cosmetically disfiguring swelling of his nipple for many years was found to have factitious mechanical pseudoainhum. The possibility of occult mechanical constriction as the cause of acute or chronic deformities of appendages is emphasized.
Ainhum↗
Miscellaneous genodermatoses: Beckwith-Wiedemann syndrome, Birt-Hogg-Dube syndrome, familial atypical multiple mole melanoma syndrome, hereditary tylosis, incontinentia pigmenti, and supernumerary nipples.
Beckwith-Wiedemann syndrome, familial atypical multiple mole melanoma syndrome, and hereditary tylosis are bona fide genodermatoses with malignant potential. Each of these conditions is associated with an increased incidence of certain tumors: Wilms' tumor, adrenocortical carcinomas, pancreatoblastomas, and hepatoblastomas in Beckwith-Wiedemann syndrome; intraocular malignant melanoma, pancreatic carcinoma, and noncolorectal gastrointestinal cancers in familial atypical multiple mole melanoma syndrome; and squamous cell carcinoma of the esophagus in hereditary tylosis. Other cancer-related genodermatoses are Birt-Hogg-Dube syndrome (associated with medullary carcinoma of the thyroid and renal cell carcinoma) and its variant, Hornstein-Knickenberg syndrome (associated with colon carcinoma). Kidney tumors (Wilms' tumor and malignant rhabdoid tumor), leukemias (acute myelogenous and acute myelomonocytic), retinoblastoma, and paratesticular rhabdomyosarcoma have been reported recently in children with another genodermatosis-incontinentia pigmenti. Supernumerary nipples (polythelia) may be sporadic or familial in occurrence; their presence has been associated with an increased incidence of renal adenocarcinoma, testicular cancer, prostate cancer, and urinary bladder carcinoma. The general characteristics, mucosal and skin manifestations, and noncutaneous features of all these conditions are reviewed. Also, the associated malignancies of these genodermatoses and other conditions that are characterized by dermatologic manifestations and may be either familial or secondary to an inherited gene defect are summarized.
Adult↗
Nipple discharge.
The evaluation and management of nipple discharge can be undertaken with minimal difficulty by performing a careful history and examination and following a logical thought process in linking the type of discharge with the suitable mode of treatment. In this manner, the patient's discharge can be efficiently and thoroughly evaluated.
Adult↗
[Surgical treatment of hidradenitis and Fox-Fordyce disease of the nipples].
Hidradenitis suppurativa and Fox-Fordyce disease are apocrine sweat gland diseases, characterized by chronic and recurrent forms, with frequently unsatisfactory management and physical discomfort. The localisation to the breast areola is well known but infrequent. A new surgical treatment of areolar involvement is presented. This technique includes: dermal detachment of the areola safeguarding the nipple, excision of the underlying apocrine sweat glands, areola fixation like a flap-total skin graft. This very simple procedure allows definitive treatment without aesthetic impairment. Two cases of areolar involvement are presented.
Adult↗
[Relationship between location and nipple discharge of breast cancer and its clinical significance].
The relationship between the location and the discharge of breast cancers in 50 cases was analyzed from May 1980 to May 1989. Those lesions were located beneath the areolae or near the areolae. Ductograms and cytology were very useful in the diagnosis. Most of them (72.7% and 69.2% respectively) belonged stage I. Five-year survival was 100% and 92.6% respectively. But those located far away from areola tended to become bigger and bigger, and invaded the large ducts. So the nipple discharge appeared. Most of them (69.2%) were in stage III. Five-year survival was 52.8%. The prognosis of this group was poorer than that of the former group.
Adult↗
Inverted nipples in Robinow syndrome.
We report a female newborn with typical clinical and radiological signs and symptoms of Robinow syndrome. We noted inverted nipples, which became only clearly evident after the age of 6 months, as a "new" associated clinical symptom in this syndrome.
Abnormalities, Multiple↗
Supernumerary nipples and accessory breast tissue.
Supernumerary nipples and supernumerary breast tissue are often dismissed as cosmetic curiosities. These structures have the potential for pathologic degeneration and may be associated with significant congenital abnormalities. In a prospective comparison of 100 Native American women to 100 non-Native American women, these accessory organs were found much more commonly in Native American women. Careful attention should be given to thorough evaluation and long term follow-up of any patient in whom this anomaly is found.
Breast↗
Male to male transmission of supernumerary nipples.
We report on a father and his son with supernumerary nipples. No male-to-male transmission has previously been described with this trait. This observation confirms that this trait is inherited in an autosomal dominant fashion.
Child, Preschool↗
Creating a realistic breast: the nipple-areola reconstruction.
Breast reconstruction is a multi-stage process, leaving many patients overwhelmed by the surgeries they have had to endure by the time they reach the final stages. Patients, however, are encouraged to complete their new breast by undergoing nipple and areolar reconstruction. These last two procedures improve the aesthetic result by transforming the surgically created breast mount into a more natural-appearing breast. This final touch enhances body image, restoring the patient's feeling of wholeness. These procedures are mostly done in the office under local or no anesthesia, depending on the sensation present in the reconstructed breast.
Female↗