Posted 3 days ago
Nipple Adenoma: A Rare but Benign Breast Lesion with a Malignant Disguise
Introduction
While breast cancer dominates headlines as one of the most common cancers in women, not all breast masses are malignant. Nipple Adenoma Cureus is a rare, benign breast lesion that can mimic the symptoms and appearance of breast cancer, making accurate diagnosis essential. This blog post explores a recent case study that sheds light on this uncommon condition—and the critical role of expert surgical care in its management.
Case Summary
A 69-year-old woman presented with a right nipple mass and chronic discharge. Imaging revealed masses in both nipples—1.1 cm on the right and 7 mm on the left. A biopsy confirmed benign nipple adenomas. Surgical excision was performed, including amputation of the right nipple due to the lesion’s size, while preserving the areola. Pathology confirmed bilateral ductal adenomas with no signs of malignancy.
Despite positive margins, the patient opted against further surgery, choosing close observation instead highlighting the importance of balancing medical recommendations with patient preferences and cosmetic outcomes.
Clinical Challenges
Nipple adenomas are rare, accounting for only 0.1–1.7% of benign breast lesions, and often present with:
Unilateral bloody nipple discharge
Palpable masses
Nipple distortion or crusting
These symptoms can closely resemble Paget’s disease or invasive ductal carcinoma, making diagnosis difficult. Imaging techniques like mammography and ultrasound often lack specificity due to the dense tissue in the nipple area.
Diagnostic Approach
Accurate diagnosis hinges on:
Histopathology: Identifying dual layers of epithelial and myoepithelial cells
Immunohistochemistry: Using markers like p63, CK5/6, and calponin to confirm benignity
Biopsy: Essential before any surgical intervention to avoid overtreatment
Treatment and Management
Complete surgical excision is the gold standard for treating nipple adenomas. However, cosmetic concerns—especially when nipple removal is involved—can influence treatment decisions. Incomplete excision carries a 25–55% recurrence risk, but in select cases, close monitoring may be a reasonable alternative.
Dr. Joseph Di Como’s Role
This case was managed and co-authored by Dr. Joseph A. Di Como, a breast surgical oncologist at Ironwood Cancer and Research Centers in Scottsdale, Arizona. Dr. Di Como’s expertise was instrumental in both the surgical management and academic reporting of this rare condition. His involvement underscores the value of specialized breast surgeons in navigating complex cases that require both clinical precision and patient-centered care.
Dr. Di Como continues to contribute to the medical literature on rare breast pathologies, helping to improve diagnostic accuracy and treatment strategies for clinicians worldwide.
Conclusion
Though benign, nipple adenomas can present like breast cancer, leading to unnecessary anxiety or even overtreatment. This case emphasizes the importance of accurate diagnosis, thoughtful surgical planning, and patient-centered care. With experts like Dr. Di Como leading the way, patients can receive the right treatment—without compromising quality of life.