A nipple adenoma is a rare benign

Benign

A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...

 tumour of the breast

Breast cancer

Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

.

The condition may also be known as :

• Florid papillomatosis of the nipple
• Florid adenomatosis
• Subareolar duct papillomatosis
• Erosive adenomatosis

Definition

A nipple adenoma is a type of intraductal papilloma

Intraductal papilloma

Intraductal papillomas of the breast are relatively common lesions with an incidence of approximately 2-3% in humans.They are the most common cause of bloody nipple discharge in women age 20-40 and generally do not show up on mammography due to their small size, so the next step in treatment would...

 that arises within the lactiferous duct

Lactiferous duct

Lactiferous ducts lead from the lobules of the mammary gland to the tip of the nipple. They are also referred to as galactophores, galactophorous ducts, mammary ducts, mamillary ducts and milk ducts...

s that are located within the nipple

Nipple

In its most general form, a nipple is a structure from which a fluid emanates. More specifically, it is the projection on the breasts or udder of a mammal by which breast milk is delivered to a mother's young. In this sense, it is often called a teat, especially when referring to non-humans, and...

.

Epidemiology

Nipple adenomas most commonly occur in 30 to 40 year old women, but can also occur in men. They can also occur at any age, including in the elderly, in adolescence, and in infants.

Signs and symptoms

Nipple adenomas may be felt as a lump

Breast lump

Breast lump is a localized swelling that feels different from the surrounding breast tissue. It is a symptom/sign for a variety of conditions. As approximately 10% of breast lumps ultimately lead to a diagnosis of breast cancer, it is important for women with a breast lump to receive appropriate...

 under the nipple or areola

Areola

This article is about the breast tissue. For the entomology term, see the glossary of Lepidopteran terms. For an artistic cloud motif, see aureola. For the cactus feature, see Areole....

. They may come to attention because of nipple pain, ulceration, swelling or discharge.

Differential diagnosis

The microscopic

Histology

Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...

 appearance of a nipple adenoma can be mistaken for carcinoma

Breast cancer

Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

. Other conditions that have similar symptoms and signs as nipple adenoma include Paget's disease of the breast

Paget's disease of the breast

Paget's disease of the breast is a malignant condition that outwardly may have the appearance of eczema, with skin changes involving the nipple of the breast....

, other intraductal papillomas, ductal carcinoma in situ (DCIS), syringomatous adenoma of the nipple and subareolar sclerosing duct hyperplasia.

Imaging

Lesions of the nipple and areola, such as nipple adenoma, may be difficult to image clearly on routine mammogram or ultrasonography. Nipple adenomas can be imaged using magnetic resonance imaging

Magnetic resonance imaging

Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...

 (MRI) and conventional or MR ductogram.

Biopsy

Once excised, the macroscopic

Macroscopic

The macroscopic scale is the length scale on which objects or processes are of a size which is measurable and observable by the naked eye.When applied to phenomena and abstract objects, the macroscopic scale describes existence in the world as we perceive it, often in contrast to experiences or...

 appearance of nipple adenomas is of a poorly defined nodular mass. The microscopic appearance can be quite bizarre, and may be misinterpreted as a carcinoma. Nipple adenomas usually have a rounded outline at low magnification, and at higher magnification can be seen to consist of a haphazardly arranged mass of proliferating tubular structures composed of epithelial

Epithelium

Epithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the cavities and surfaces of structures throughout the body, and also form many glands. Functions of epithelial cells include secretion, selective...

 and myoepithelial

Myoepithelium

Myoepithelial cells are cells usually found in glandular epithelium as a thin layer above the basement membrane but generally beneath the lumenal cells. These may be positive for alpha smooth muscle actin and can contract and expel the secretions of exocrine glands...

 cells within varying amounts of fibrous

Fibroblast

A fibroblast is a type of cell that synthesizes the extracellular matrix and collagen, the structural framework for animal tissues, and plays a critical role in wound healing...

 stroma

Stroma (animal tissue)

In animal tissue, stroma refers to the connective, supportive framework of a biological cell, tissue, or organ.The stroma in animal tissue is contrasted with the parenchyma.Examples include:* Stroma of iris...

. The epithelial cells are usually columnar, but the columnar epthelial cells can undergo apocrine

Apocrine

Apocrine is a term used to classify exocrine glands in the study of histology. Cells which are classified as apocrine bud their secretions off through the plasma membrane producing membrane-bound vesicles in the lumen. This method is also called decapitation secretion...

 or squamous metaplasia

Metaplasia

Metaplasia is the reversible replacement of one differentiated cell type with another mature differentiated cell type. The change from one type of cell to another may generally be a part of normal maturation process or caused by some sort of abnormal stimulus...

. Mitotic figures

Mitosis

Mitosis is the process by which a eukaryotic cell separates the chromosomes in its cell nucleus into two identical sets, in two separate nuclei. It is generally followed immediately by cytokinesis, which divides the nuclei, cytoplasm, organelles and cell membrane into two cells containing roughly...

 and necrosis

Necrosis

Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

 are not commonly seen.

Treatment

The appropriate treatment in contemporary western medicine is complete surgical

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 excision of the abnormal growth with a small amount of normal surrounding breast tissue.

Prognosis

Nipple adenomas are non-cancerous

Benign

A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...

growths, which can recur if not completely surgically removed. There are reported cases of cancers arising within nipple adenomas, and following excision of nipple adenomas, but these are rare occurrences.