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At least 109 records · Page 6Linked to original sources
PubMed1994

Breast cancer diagnosis by lactate dehydrogenase isozymes in nipple discharge.

BACKGROUND: The diagnosis of breast cancer based on nipple discharge, often the only clinical manifestation of early breast cancer, is currently unsatisfactory. Because M subunits of lactate dehydrogenase (LDH) have been noted to increase in cancer tissue, the author assessed the value of using LDH isozyme patterns in nipple discharge for the diagnosis of breast cancer. METHODS: LDH isozyme levels in (1) nipple discharge of patients diagnosed as having breast cancer, intraductal papilloma, mastopathy, drug-induced nipple discharge, mastitis, or benign nipple discharge; (2) control samples of normal nipple discharge (milk) 6 days, 1-5 months, and 6 months to 2 years postpartum; (3) the serum of patients presenting with nipple discharge; and (4) normal and cancerous breast tissue extracts were measured using a Ciba-Corning LDH isozyme system (Ciba Corning Diagnostic Corp., Tokyo, Japan). RESULTS: LDH isozyme levels in the nipple discharge of patients with benign breast diseases displayed various patterns. Levels in the nipple discharge of patients with breast cancer, including noninvasive carcinoma, tended to increase in ascending order from LDH1 to LDH5. This pattern was similar to that in breast cancer tissue and was unrelated to the pattern in serum. CONCLUSION: LDH isozyme assay of nipple discharge may be a useful technique for providing a supporting diagnosis of breast cancer.

Biomarkers, Tumor↗
PubMed2004

Diagnostic value of nipple cytology: study of 466 cases.

BACKGROUND: Nipple discharge/scraping cytology is a simple, noninvasive method that complements patient assessment. Despite low reported sensitivities for detecting malignancy, the authors predicted that this method would provide important diagnostic information when applied to patients with nonphysiologic nipple discharge or eczematous nipple lesion. METHODS: From 1995-2002, 466 case specimens from 395 patients were evaluated by nipple discharge or scraping cytology. Of the 98 patients with abnormal cytologic findings, histologic follow-up was available for 45 cases (39 patients). After review, each case was categorized as negative or positive for malignancy. Cytologic findings were compared with the findings of subsequent biopsy or excision of the affected duct or nipple lesion. RESULTS: Of the 13 cases of in situ or invasive carcinoma diagnosed by histology, 11 had positive cytology (sensitivity, 85%). Two malignant cases were not represented by preceding cytology and one case with positive cytology failed to demonstrate malignancy after a subsequent biopsy was performed (specificity, 97%). Clinically, all but one case of malignancy was associated with a serosanguinous discharge or eczematous nipple lesion. The cytology of all malignant cases showed dyshesive epithelial cell groups and single cells with prominent nucleoli in a bloody background. The positive predictive value for cytology was 92% and the negative predictive value was 94%. CONCLUSIONS: Cytologic examination of nipple discharge and nipple lesion scrapings is highly specific and sensitive in the detection of carcinoma when applied to patients with unilateral serosanguinous nipple discharge or an eczematous nipple lesion.

Adult↗
PubMed1992

Oral capture and grasping of an artificial nipple by rat fetuses.

Although born blind and deaf, newborn rats exhibit a remarkable capacity to recognize and gain access to the nipples of the lactating mother. However, it is well-known that full-term rat neonates will not attach to an artificial nipple. In the present study, an artificial nipple fashioned from soft vinyl was presented to rat fetuses from E17-E21 of gestation. Fetuses showed side-to-side head movements that resulted in oral capture of the nipple on E18 and exhibited a direct nipple-grasping response from E19 through term. Frame-by-frame analysis of videotape records of E21 rat fetuses revealed that tactile contact with the artificial nipple elicited mouthing, licking directed at the nipple, forelimb treadling, and grasping of the nipple. Fetuses also exhibited components of aversive behavior, including facial wiping and head turning, that appeared to terminate oral contact with the nipple. Morphine pretreatment reduced the expression of aversive responses and promoted licking and grasping of the artificial nipple. In addition to documenting the prenatal ontogeny of this important neonatal behavior, these findings imply a role for endogenous opioids in the newborn rat's first suckling episode.

Animals↗
PubMed2003

A case of male noninvasive intracystic papillary carcinoma forming a tumor in the nipple duct.

Epithelial tumors forming a mass in the male nipple are very rare. Paget's disease, adenoma of the nipple (AON), and breast cancer must be considered for differential diagnosis. This report presents a 72-year-old man with spontaneous serous nipple discharge and an enlarged nipple measuring 2 cm in diameter. Ultrasonography provided no useful information regarding the nipple lesion. Nipple discharge cytology was negative and without any inflammatory cells. Since it is extremely uncommon for Paget's disease and breast cancer to cause tumor in the nipple, AON was suggested. However, histopathological examination of the nipple resection revealed noninvasive intracystic papillary carcinoma of the nipple. Biopsy of the nipple is often necessary to diagnose this disease. Moreover, excisional biopsy of the tumor is recommended when possible, since it can accomplish both diagnosis and treatment in cases of AON or noninvasive intracystic papillary carcinoma.

Aged↗
PubMedDate not supplied

Filler injection enhances the projection of the reconstructed nipple: an original easy technique.

BACKGROUND: Reduced nipple projection is the main reason for unsatisfactory nipple-areola complex reconstruction, and many techniques have been proposed to maintain projection of the reconstructed nipple. METHODS: For 70 patients, 90 nipples were reconstructed using either a small wedge from the labia minora (LMW) (n=70) or nipple sharing (NS) (n=20). Two months after reconstruction, each reconstructed nipple was injected with DermaLive. Second and third injections were performed 2 and 5 months later. The injected volume was tailored to the desired projection. Nipple projection was measured at the moment of implant, before and after each injection, and 6 and 12 months after the last injection. RESULTS: Nipple projection was satisfactory in all cases and comparable with that of the contralateral nipple. The average nipple projection at 6 months was 5.8 mm in the LMW group and 3.8 mm in the NS group (p<0.01) and, respectively, 5.6 mm and 3.5 mm at 12 months (p<0.01). No complications occurred, except for one positron emission tomography (PET) false-positive result. CONCLUSIONS: The described method is simple and safe. It provides precise projection with no need for intraoperative forecasting of tissue reabsorption. The result was better for the LMW patients, perhaps because of their higher distensibility.

Acrylates↗
PubMedDate not supplied

Nipple attachment behavior in rat pups exposed to alcohol in utero.

Two experiments were conducted to further characterize impaired nipple attachment behavior in 5-day-old rat pups exposed to alcohol prenatally. In Experiment 1, animals were given two different nipple attachment tests. In the pups-on-mother test, which required animals to first locate a nipple, alcohol-exposed pups displayed longer attachment latencies than controls. Furthermore, more than 50% of these pups failed to attach during testing. In the pups-on-nipple test, in which no search for the nipple was necessary, prenatal alcohol did not reliably affect attachment. To assess the extent to which alcohol-exposed pups utilize an olfactory cue for attachment, in Experiment 2, nipple attachment was observed using the pups-on-nipple test before and after olfactory cue removal. Similar to controls, the alcohol-exposed animals only attached to the normally scented nipples. Therefore, prenatal alcohol exposure impaired nipple search performance in young rats, but not attachment once at the nipple. Moreover, these pups performed like controls in response to olfactory cue manipulation. Possible mechanisms for the poor search behavior are discussed.

Animals↗
PubMed2006

Long-term nipple shrinkage following augmentation by an autologous rib cartilage transplant in free DIEP-flaps.

Aesthetically pleasing nipple-areola reconstruction is a satisfying part of a two-stage breast reconstruction. The up to 50% [Banducci DR, Le TK, Hughes KC. Long-term follow-up of a modified Anton-Hartrampf nipple reconstruction. Ann Plast Surg 1999;43(5):467-9; discussion 469-70] postoperative shrinkage following a conventional nipple reconstruction is a well-known problem. Augmentation of the nipple with autologous banked cartilage seems to be a promising solution. From 2000-2003, 17 patients underwent a nipple-areola-complex reconstruction following secondary breast reconstruction using free perforator flaps. The rib cartilage harvested during the preparation of the internal thoracic vessels was banked subcutaneously and six months later replanted under the 'arrow flap' after contouring it in a 'mushroom' shape. One year later the shrinkage of the nipple in comparison to the intraoperative status was measured. In addition, patients were asked about their personal palpation impression and the aesthetic outcome. The average height decreased one year postoperatively about 25%. Thirteen of 17 patients judged the aesthetic outcome as very good, 16 nipples healed without cartilage protrusion and no patient felt discomfortable stiffness of the nipple. Our concept of a nipple augmentation with rib cartilage improves the projection and allows a more correct judgement of the later nipple shrinkage. We consider this technique to be an aesthetically satisfying and safe method, which could be used with any kind of breast reconstruction.

Cartilage↗
PubMed1985

Papilla (nipple) development in puberty. The adolescent male.

Papilla (nipple) development was studied in 230 males (119 black, 111 white) aged 3-29 years to compare this development to the established criteria for sexual maturation. Comparison was also made with a previous study of female nipple development to determine whether or when any differences between male and female nipple development occurred. Our male subjects were further assessed to determine if nipple size differed in the presence or absence of gynecomastia. Significant nipple development occurred between pubic hair stages PH1 (diameter 2.8 mm), PH4 (4.4 mm), and PH5 (5.4 mm). Similarly, there was significant incremental growth between genital stages G1 (3.0 mm), G3 (4.6 mm), and G5 (5.5 mm). Nipple development was similar in both sexes through stage PH3, but significantly diverged at stage PH4 (p less than 0.000001) because of a marked increase in female nipple diameter. Boys with gynecomastia had a significantly larger nipple size than boys who had none (p less than 0.001). Differences in nipple diameter between the sexes and between boys with and without gynecomastia probably result from differences in estrogen levels. Perhaps in the future, it will be possible on the basis of nipple diameter to predict which adolescent boys will have persistent gynecomastia.

Adolescent↗
PubMed1981

[The correlation between evidence of breast-cancer in the nipple and the axillary lymph nodes in cancer of the breast in women (author's transl)].

In a random sample of 1,000 mastectomies from microscopically proven cancer of the breast the concomitant evidence of cancer in the nipple and the axillary lymph nodes were studied. Cases with evidence of cancer in the nipple showed axillary metastases twice as often as cases without evidence of cancer in the nipple. In cases with diffuse or lymphangetic evidence of cancer in the nipple the incidence of metastases in the axillary lymph nodes was twice as high in cases with intra-ductal or paget type evidence of carcinoma in the nipple. In cases with evidence of cancer in the nipple, the incidence of metastases in the axillary lymph nodes decreases more with age than in cases without evidence of breast cancer in the nipple. With increasing tumour size the evidence of breast cancer in the axillary lymph nodes was higher in cases without evidence of cancer in the nipple than in cases with evidence of cancer in the nipple. The microscopic differentiation and the grade of malignancy also had an influence on the incidence of axillary metastases in correlation to evidence of cancer in the nipple.

Age Factors↗
PubMed1999

The inverted nipple: its grading and surgical correction.

Inverted nipples have been treated by various methods by many authors, but the relationship between the grade of the deformity and the appropriate surgical procedure is not clearly described. One hundred seven inverted nipples in 60 patients were treated from 1993 to 1997. They were divided into three groups by the authors' system of grading. The grade was made by preoperative evaluation of severity of inversion and was confirmed by the surgical findings. In grade I, the nipple is easily pulled out manually and maintains its projection quite well. Grade I nipples are believed to have minimal fibrosis; thus, manual traction and a single, buried purse-string suture are enough for the correction. The majority of inverted nipples belong to grade II, i.e., the nipples can be pulled out but cannot maintain projection and tend to go back again. These nipples are thought to have moderate fibrosis beneath the nipple. Blunt dissections for surgical release were carried out until the inversion did not recur after releasing the traction. The lactiferous ducts could be identified and preserved, permitting proper release of fibrotic bands in the grade II group. The purse-string suture was used. In grade III, to which the least number of inverted-nipple cases belong, the nipple can hardly be pulled out manually. Severe fibrosis made it impossible to reach optimal release of the fibrotic band with the preservation of the ducts. The fibrotic bands are widely dissected, and the lactiferous ducts are cut, especially in the central portion. Two or three deepithelialized dermal flaps may be used to make up for soft-tissue deficiency; a purse-string suture is also used. This grading system will be useful for patient classification and analysis, systematic planning, and application of the proper surgical procedures.

Breast Diseases↗
PubMed2001

Nipple reconstruction using the C-V flap technique: a long-term evaluation.

Numerous procedures are available for nipple reconstruction with no true universal favorite. This study presents long-term follow-up data for nipple reconstruction using the C-V flap technique. Patients were identified by searching the Breast Reconstruction Database, and they were asked to return for a follow-up visit. All those who underwent nipple reconstruction using the C-V flap technique between January of 1992 and December of 1996 were reviewed in an attempt to conduct a long-term follow-up evaluation. The response was poor, and 11 patients participated in the study and returned for follow-up. They all completed a questionnaire, which focused on patient satisfaction using a visual analogue scale. Nipple measurements were taken with a caliper and compared with the opposite breast for symmetry. Fourteen nipple reconstructions were evaluated in 11 patients with an average follow-up of 5.3 years. All patients had undergone transverse rectus abdominis musculocutaneous (TRAM) flap reconstructions. Patient satisfaction was 42 percent with nipple projection, 62 percent with pigmentation, and 26 percent with sensation. Overall patient satisfaction with the procedure was 81 percent. Average nipple projection of the reconstructed nipple was 3.77 mm and was not statistically different when compared with the opposite nipple. Long-term subjective evaluation of the C-V flap technique does report a loss in nipple projection; however, overall patient satisfaction at 5.3 years is good, as is the ability to restore symmetry with the opposite breast.

Adult↗
PubMed2006

Microanatomy of milk ducts in the nipple.

The aim of this study was to determine number and diameter of milk ducts in the nipple and to investigate the possible influences of age, breast weight, and diameter of the nipple on the number of ducts. Two hundred and twenty-six carcinoma mastectomy specimens were weighed and the nipple diameters measured. The number of ducts was counted in histological cross sections. Mean diameter of the nipple and mean breast weight were 13.9 mm and 844.6 g, respectively. There was a small but statistically significant positive correlation between nipple diameter and number of milk ducts (rho = 0.158; p = 0.01), but no correlation with breast weight. The mean number of ducts in the nipple duct bundle was 17.5. This is significantly higher than the number of ducts reported to open on the nipple surface. This discrepancy could reflect duct branching within the nipple or the presence of some ducts which do not reach the nipple surface. Smaller breast ducts (diameter < 0.5 mm) represent nearly 50% of the nipple ducts and could be a challenge to the ductoscopy technology.

Adult↗
PubMedDate not supplied

The male genital tract and the nipples of male and female offspring of rats given the non-steroidal antiandrogens DIMP and Sch 13521, during pregnancy.

Male and female offspring of rats given antiandrogens, the steroidal BOMT or the non steroids DIMP or Sch 13521, daily during the last third of pregnancy were studied. Detailed examinations were made of the genital tract of male, and of the nipples of male and female offspring. A) Male offspring. 1) Genital tract of newborn and 31-91 day old males : Modifications of the development of accessory sexual tissues were found in all treatment groups. As indicated by the severity of deviations from normal (morphology and weight of sex accessories), the antiandrogenic effect of the preparations, in the doses given to the mother rats, increased from BOMT (50 or 75 mg/day) via Sch 13521 (30 mg/day) and DIMP (50 or 60 mg/day) to Sch 13521 (60 mg/day). 2) Nipples of 10-60 day old males : Whole mount preparations were made unilaterally of the row of 6 mammary glands with nipples. The number of intact and abnormal nipples, respectively, was recorded. The relation between intact and abnormal nipples served as indicator of the efficiency of the antiandrogenic substances studied. The result showed that the antiandrogenic effect increased from BOMT to Sch 13521, 60 mg, in the same order as that arrived at from studies of the genital tract. The combined results obtained from the male offspring indicated that the tissues of the genital region, the growth and differentiation of which was most readily impaired by antiandrogens, were the same as those known from other work to be stimulated most easily in female rat fetuses by testosterone. B) Female offspring. Nipples of 31-60 day old females were judged from whole mount preparations and recorded as in the males. The nipples of adult virginal females were examined macroscopically. The same procedure was applied to lactating females, but the results were controlled in consecutive lactational periods and at autopsy. The 3 groups of females showed uniformly that 1) offspring of rats given BOMT during pregnancy had many (about 50 per cent) malformed nipples and 2) the treatment of mother rats with DIMP or Sch 13521 did not influence the development of nipples in female offspring. The result was assumed to be due to an androgenic effect of the steroidal antiandrogen, BOMT, on the nipple anlage.

Abnormalities, Drug-Induced↗
PubMed2004

[Correction of congenital nipple inversion with bilateral rhombus deepithelialized subcutaneous pedicle skin flaps and continuous traction].

OBJECTIVE: A new method for correction of nipple inversion was introduced to improve the surgical result. METHODS: In this procedure, two opposite rhombus incisions on both sides of the inverted nipple were designed within the range of areola. The rhombus skin was deepithelialized and two subcutaneous pedicle skin flaps were created. Then the shortened lactiferous ducts and fibrous bands beneath the nipple were released. The subcutaneous pedicle skin flaps on both sides of the inverted nipple were advanced through the tunnel beneath the nipple as the supporting tissue. After the operation, continuous traction of the nipple lasted two weeks at least. RESULTS: Since 1999, 16 patients with congenital bilateral nipple inversion have been treated. No complications were found in all the cases. Postoperative follow-up for 2-12 months showed that the appearance of the nipple was satisfactory. CONCLUSIONS: This method is simple, safe and effective for correction of congenital nipple inversion. The incision scar is indistinct, the natural look and good function of the nipple were reserved.

Adolescent↗
PubMed1998

Calibrated-orifice nipples for measurement of infant nutritive sucking.

To measure infant nutritive sucking reproducibly, nipple flow resistance must be controlled. Previous investigators have accomplished this with flow-limiting venturis, which has two limitations: flow resistance is highly dependent on fluid viscosity and older infants often reject the venturi nipple. This report describes the validation of calibrated-orifice nipples for the measurement of infant nutritive sucking. The flow characteristics of two infant formulas and water through these nipples were not different; those through venturi nipples were (analysis of variance; p < 0.0001). Flow characteristics did not differ among calibrated-orifice nipples constructed from three commercial nipple styles, indicating that the calibrated-orifice design is applicable to different types of baby bottle nipples. Among 3-month-old infants using calibrated-orifice nipples, acceptability was high, and sucking accounted for 85% of the variance in fluid intake during a feeding. We conclude that calibrated-orifice nipples are a valid and acceptable tool for the measurement of infant nutritive sucking.

Bottle Feeding↗
PubMed1994

Fetal experience with milk or an artificial nipple alters appetitive and aversive responses to perioral cutaneous stimuli.

Fetal rats exhibit oral grasping of an artificial nipple. The authors examined interactive effects of sensory stimuli normally encountered in the suckling environment on subsequent responses to the nipple. Embryonic Day 20 rat fetuses received an infusion of milk, lemon, or saline through a hollow artificial nipple or an intraoral cannula (producing no nipple stimulation). One minute after sensory pretreatment, behavioral responses of fetuses to an artificial nipple were recorded on videotape for frame-by-frame analysis. Preexposure to the artificial nipple decreased the number of oral grasps and facial wipes directed toward the artificial nipple but increased the duration of grasp responses. Milk uniformly reduced fetal responsiveness to the nipple. Furthermore, the artificial nipple enhanced fetal responses to perioral cutaneous stimulation, whereas milk suppressed perioral responsiveness. These data suggest that the perinatal rat's 1st experience with milk or the nipple can alter subsequent responses to suckling stimuli.

Animals↗
PubMed1990

[Afferent nipple valve malfunction as a late complication of the Kock continent ileal reservoir].

Construction of a continent ileal urinary reservoir (Kock pouch) is associated with a high incidence of late complication because of malfunction of the nipple valve, the efferent limb in particular. We have so far experienced several types of afferent nipple malfunction. We herein report on the unexpected complications of the afferent nipple valve in patients with a post operative observation of 1 year or more. From 1984 through 1989, urinary diversion via a Kock pouch was performed on 47 patients at Kyoto University Hospital and Public Toyooka Hospital. The study group comprises 42 patients with a mean observation of 40 months (range 14 to 60 months). The late complications of the afferent nipple valve were observed in 11 of the 42 (26%) patients. These included erosion of Dacron fabric used as a collar (5 patients), afferent nipple stenosis (3 patients) and afferent nipple obstruction by mucous plug or fungus ball (3 patients). Removal of Dacron collar was performed in 4 of the 5 patients with collar erosion and in 1 of the 3 patients with nipple stenosis. Nipple obstruction was relieved by endoscopic manipulation or diuresis. All of the 11 patients had no problems with their efferent nipples. Our results suggest that the use of nonabsorbable material as a collar and peristaltic direction of the afferent limb are mainly involved in the complications of the afferent nipple. A more reliable and simpler procedure for antireflux anastomosis should be considered.

Adult↗
PubMed1987

Nipple preservation during mastectomy.

In a retrospective study of 100 patients with operable breast cancer, microscopic involvement of the nipple-areola complex was found in 16 cases. Each of these 16 cases occurred in patients with centrally situated tumours. In contrast, nipple involvement did not occur with peripherally situated tumours lying greater than 2 cm outside the areolar margin (P less than 10(-6), Fisher's exact test). Nipple involvement was more likely in patients with greater than or equal to 4 positive axillary nodes (P less than 0.01, chi 2 test). From this study it appears that nipple preservation may be undertaken during mastectomy for small peripheral tumours, provided the nipple is clinically normal, and frozen section analysis of the sub-nipple area is shown to be free from tumour invasion. These criteria for nipple preservation were satisfied in 20 patients out of a prospective series of 60. In this group, nipple preservation on the skin flap improved the cosmetic result of breast reconstruction in 35 per cent, and facilitated skin closure in 20 per cent. After a mean follow-up period of 50.4 months, nipple preservation was not associated with any significant excess of local recurrences.

Breast↗