-
The Surgical Clinics of North America Dec 2022There are many dermatologic conditions that can involve the skin of the breast including malignancy, infections, and inflammatory conditions. These are summarized here... (Review)
Review
There are many dermatologic conditions that can involve the skin of the breast including malignancy, infections, and inflammatory conditions. These are summarized here including presentation and management options.
Topics: Humans; Female; Nipples; Skin; Breast Neoplasms; Breast; Mammaplasty
PubMed: 36335924
DOI: 10.1016/j.suc.2022.07.003 -
Current Problems in Dermatology 2022Cosmetic tattooing dedicated to beautifying the normal anatomy such as the eyebrows, the eyelines, or the lips is in a remarkable growth all over the world. Medical... (Review)
Review
Cosmetic tattooing dedicated to beautifying the normal anatomy such as the eyebrows, the eyelines, or the lips is in a remarkable growth all over the world. Medical tattooing with reconstruction of the areola and the nipple after breast surgery, correction of the lost color of vitiligo and scars is a spin-off, which has made tattooing cross the barrier and become accepted and used in clinics and hospitals in service of the quality of life of patients. The last years have seen a major development of machinery, inks, techniques, experiences, and services. The overwhelming rise of the activity created by client pressure and business opportunity, however, also has its cons: amateur work and even malpractice. The development is driven by elite technicians, but competence is little transparent to clients, and there is no distinct authoritative recognition of practitioners based on a recognized educational curriculum. National regulations of the industry are highly variable and scattered. Some countries have no restriction and in others cosmetic tattoos shall be performed by medical doctors. The challenge of the coming decades is to parallel the success of the industry with quality assurance to better control practices and safeguard clients, and the patients.
Topics: Humans; Tattooing; Quality of Life; Nipples; Mastectomy; Lip
PubMed: 37263214
DOI: 10.1159/000525184 -
Advances in Experimental Medicine and... 2020Paget's disease of the breast (PDB) is a rare breast carcinoma believed to arise from an underlying in situ or invasive ductal cancer that migrates through the epidermis... (Review)
Review
Paget's disease of the breast (PDB) is a rare breast carcinoma believed to arise from an underlying in situ or invasive ductal cancer that migrates through the epidermis causing characteristic skin changes including scaling, redness, and itching of the nipple, areola, and sometimes the surrounding skin. Although Paget's may mimic benign conditions such as contact or allergic eczema and mastitis, it should remain a strong consideration in the differential diagnosis , especially in peripartum women for whom benign conditions such as bacterial mastitis from breastfeeding are common. The workup of Paget's should focus on both making the diagnosis with nipple/skin scrape cytology or punch biopsy as well as evaluating any underlying mass with mammogram, breast ultrasound , and also a core needle biopsy , if required. Treatment focuses on management of the underlying breast cancer as usual. The purpose of this chapter is to describe the presentation of PDB as well as outline an approach to its diagnosis and management, especially in the setting of pregnancy and lactation.
Topics: Breast Neoplasms; Diagnosis, Differential; Female; Humans; Lactation; Nipples; Paget's Disease, Mammary; Pregnancy; Pregnancy Complications, Neoplastic
PubMed: 32816273
DOI: 10.1007/978-3-030-41596-9_18 -
Journal of Cosmetic Dermatology Jun 2022Nipple-areola complex is a naturally hyperpigmented skin area which can be involved in vitiligo. But limited study focused on the treatment of nipple-areola complex...
BACKGROUND
Nipple-areola complex is a naturally hyperpigmented skin area which can be involved in vitiligo. But limited study focused on the treatment of nipple-areola complex vitiligo, and few methods were proven to be effective. In this study, we aimed to explore the feasibility and efficacy of ReCell® on vitiligo in the nipple-areola complex area.
METHODS
Medical records of patients with vitiligo involving nipple-areola complex and underwent ReCell® treatment from October 2016 to April 2020 were retrospectively reviewed. The repigmentation rate of the nipple-areola complex and other breast area were calculated under the Wood's light at each follow-up. The grade of repigmentation and patient-reported satisfaction rate were also evaluated to prove the effect of ReCell® on vitiligo of breast and especially in the nipple-areola complex area.
RESULTS
A total of 18 patients were included in this study. No surgical complications were reported. The mean postoperative repigmentation rate in the nipple-areola complex area (3rd-month, 78.7 ± 5.8%; 6th-month, 87.6 ± 5.1%; and 12th-month, 96.1 ± 3.5%) was significantly higher than that in the other breast treatment area (3rd-month, 70.4 ± 6.9%; 6th-month, 84.2 ± 5.7%, and 12th-month, 93.2 ± 3.6%). All patients showed good or excellent grades at the last follow-up, and 94.4% of them considered the overall treatment results satisfactory.
CONCLUSIONS
ReCell® is a feasible and efficient treatment strategy in the nipple-areola complex vitiligo.
Topics: Humans; Nipples; Patient Satisfaction; Retrospective Studies; Treatment Outcome; Vitiligo
PubMed: 34416080
DOI: 10.1111/jocd.14399 -
Aesthetic Plastic Surgery Aug 2021Herniated or pseudoherniated nipple-areolar complex (NAC), also called protuberant or "domed nipple," is an entity that can be present both in males and females and...
BACKGROUND
Herniated or pseudoherniated nipple-areolar complex (NAC), also called protuberant or "domed nipple," is an entity that can be present both in males and females and represents a therapeutic challenge. It can be an isolated deformity, but in most cases is found within another breast deformity, such as tuberous breast or can appear following pregnancy. Its diagnosis and appropriate treatment become important when patients search for correctional breast surgery.
OBJECTIVE
To review some common techniques for the treatment of tuberous breasts that address the nipple-areola problem as well, but also to present our experience with some newer and less invasive surgical techniques that could be useful for isolated treatment of herniated or pseudoherniated nipple.
METHOD
We performed a retrospective study that included all patients operated from December 2013 to December 2018. We reviewed existing techniques which in addition to our personal experience helped us to create an algorithm to assist surgeons in this matter.
RESULTS
A total of 125 patients with herniated or pseudoherniated NAC were treated. There were 87 women and 38 men. The average age of the patients was 30, 8 ± 8.1 years (ranging from 20 to 63). We analyzed the results of four following techniques: periareolar mastopexy (52 patients), release of fibrous tissue in combination with lipofilling (19 patients), resection of herniated breast tissue (23 patients) or controlled electrocoagulation of relaxed erectile muscle (31 patients). The minimum follow-up for all cases was 4 months.
CONCLUSION
The achievement of a successful aesthetic result is possible in a single-stage procedure with initial surgery. It depends on careful individual preoperative evaluation of anatomical features and a surgical approach chosen accordingly.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
Topics: Adult; Esthetics; Female; Humans; Male; Mammaplasty; Middle Aged; Nipples; Retrospective Studies; Surgical Flaps; Treatment Outcome; Young Adult
PubMed: 33999222
DOI: 10.1007/s00266-021-02308-1 -
The American Journal of Surgical... Aug 2023Nipple adenoma (NA) is a rare, benign proliferation of the nipple ducts. It may be clinically mistaken for Paget disease or squamous cell carcinoma; thus, microscopic...
Nipple adenoma (NA) is a rare, benign proliferation of the nipple ducts. It may be clinically mistaken for Paget disease or squamous cell carcinoma; thus, microscopic evaluation is paramount. A large case series of NA has not been undertaken since the 1980s. Therefore, we undertook this study to evaluate the clinicopathologic characteristics of NA, emphasizing differential diagnoses and follow-up data. We retrieved 50 cases from our in-house archives or consultation files between 2003 and 2022. Available slides were reviewed, and clinical data and follow-up information were obtained. Cases must have exhibited a dense ductal proliferation in the breast tissue with proximity to the nipple epidermis. All patients were women; median age was 56 years. In all, 68% of patients were symptomatic; 53% demonstrated a skin growth. Overall, 67% were excised completely, either primarily (33%) or via re-excision after biopsy (33%). Four histologic patterns were noted: adenosis (dense proliferation of small-to-medium ducts); large duct (medium-to-large caliber ducts); papillary-like (frond-like architecture with branching, slit-like lumens); and pseudoinfiltrative (ducts squished and distorted by dense stromal fibrosis). Follow-up in 44 patients (88%) with a median time of 66 months showed no evidence of recurrence. NA demonstrates a wide spectrum of histopathologic variation. Subtyping of this entity is unlikely to be clinically relevant. Differentiation from invasive carcinoma or other histologic mimics (syringocystadenoma papilliferum, syringomatous adenoma) may be difficult. Simple excision is curative, and recurrence is rare. A definitive link to invasive carcinoma has not been established.
Topics: Humans; Female; Middle Aged; Male; Breast Neoplasms; Adenoma; Nipples; Adenocarcinoma
PubMed: 37272622
DOI: 10.1097/PAS.0000000000002063 -
Plastic and Reconstructive Surgery Sep 2023Women of reproductive age are chronically underrepresented in breast cancer studies. Recent studies suggest that almost 40% of patients diagnosed with breast cancer who...
BACKGROUND
Women of reproductive age are chronically underrepresented in breast cancer studies. Recent studies suggest that almost 40% of patients diagnosed with breast cancer who are of reproductive age want to have children after completing treatment. In this study, the authors evaluated patients of reproductive age who had undergone nipple-sparing mastectomy (NSM) and implant-based reconstruction. The authors compared those who became pregnant with those who did not with respect to clinical and radiologic changes that are reported at follow-up.
METHODS
Any patient 45 years of age or younger at the time of NSM was determined to be of reproductive age, selected for evaluation, and followed prospectively. The presence or absence of breast examination changes in the setting of pregnancy after NSM was recorded.
RESULTS
A total of 36 patients became pregnant after NSM, and 158 patients did not become pregnant after NSM. Of those who became pregnant, nearly half reported some clinical change just before or immediately after delivery. These changes included color change and discharge at the residual nipple-areola complex and palpable nodularity elsewhere. For those with palpable changes, an ultrasound was performed and hypoechoic lesions with variable vascularity were identified. For those who went on to excision, lactational hyperplasia was the most common diagnosis.
CONCLUSIONS
Ultrasound is an appropriate first-line investigation of breast changes, which can include hyperplasia of remaining ductal and glandular tissue. Patients who became pregnant after NSM commonly had clinical breast examination changes, but the majority of these changes were found to be benign on further evaluation.
CLINICAL QUESTION/LEVEL OF EVIDENCE
Risk, II.
Topics: Pregnancy; Child; Female; Humans; Breast Neoplasms; Mastectomy; Nipples; Hyperplasia; Mastectomy, Subcutaneous; Mammaplasty; Retrospective Studies
PubMed: 36727812
DOI: 10.1097/PRS.0000000000010199 -
Radiologic Technology May 2021Ductography is an imaging procedure that uses a contrast medium to visualize breast ducts. It is performed on patients who have pathologic nipple discharge to locate...
Ductography is an imaging procedure that uses a contrast medium to visualize breast ducts. It is performed on patients who have pathologic nipple discharge to locate abnormalities in the ducts and guide surgical excision of lesions. This article discusses when and how ductography should be performed, normal and abnormal findings on ductograms, and some conditions commonly diagnosed with ductography. Arguments for and against replacing ductography with magnetic resonance imaging of the breasts also are presented.
Topics: Breast Diseases; Breast Neoplasms; Contrast Media; Female; Humans; Magnetic Resonance Imaging; Mammography; Nipples
PubMed: 33903276
DOI: No ID Found -
International Journal of Environmental... Dec 2022A number of studies have reported breasts have high fluctuating asymmetry (FA:|Right-Left|), suggesting that they contain evolutionary and clinical information (e.g.,...
BACKGROUND
A number of studies have reported breasts have high fluctuating asymmetry (FA:|Right-Left|), suggesting that they contain evolutionary and clinical information (e.g., high FA correlates with breast cancer risk). Here we focus on breast FA in women with a wide range of breast sizes, including participants with macromastia and/or gigantomastia.
MATERIAL AND METHODS
The sample included 65 women (mean age 33.97 ± 12.1 years). Thirty were randomly selected students and/or patients who regarded their breast size as small, normal or average and who had not undergone or intended to have any breast surgery. The remainder ( = 35) were qualified for breast reduction due to macromastia and/or gigantomastia. In all participants we measured/calculated weight, height and BMI, as well as took chest photographs. Breast volumes and nipple areola complex FAs were evaluated in a specifically-designed software.
RESULTS
Breast size significantly positively correlated with breast volume FA in all women (t = 5.17, < 0.0001) and in women with macromastia/gigantomastia (t = 2.32, = 0.027). All nipple location FAs correlated positively with breast size.
CONCLUSIONS
In women with different breast sizes, breast size correlates with FA calculated from breast volume and nipple location FAs. In women with macromastia and/or gigantomastia, breasts present higher FA than "normal" breasts. This observation may give a rationale for earlier and more frequent prophylactic breast imaging in women with macromastia and/or gigantomastia.
Topics: Female; Humans; Young Adult; Adult; Middle Aged; Hypertrophy; Nipples; Mammaplasty; Mastectomy
PubMed: 36554776
DOI: 10.3390/ijerph192416895 -
Radiographics : a Review Publication of... 2022Nipple-sparing mastectomy (NSM) is increasingly offered to patients undergoing treatment of breast cancer and prophylaxis treatment for reduction of breast cancer risk....
Nipple-sparing mastectomy (NSM) is increasingly offered to patients undergoing treatment of breast cancer and prophylaxis treatment for reduction of breast cancer risk. NSM is considered oncologically safe for appropriately selected patients and is associated with improved cosmetic outcomes and quality of life. Accepted indications for NSM have expanded in recent years, and currently only inflammatory breast cancer or malignancy involving the nipple is considered an absolute contraindication. Neoplasms close to and involving the nipple areolar complex are common, and cancer of the lactiferous ducts can spread to the nipple. Therefore, accurate determination of nipple involvement at imaging examinations is critical to identifying appropriate candidates for NSM and preventing local recurrence. Multiple imaging features have been described as predictors of nipple involvement, with tumor to nipple distance, enhancement between the index malignancy and the nipple, and nipple retraction demonstrating the highest predictive values. These features can be assessed at multimodality breast imaging, particularly at breast MRI, which demonstrates high specificity and negative predictive value for determining nipple involvement in malignancy. RSNA, 2022.
Topics: Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Nipples; Quality of Life; Radiologists; Retrospective Studies
PubMed: 35179983
DOI: 10.1148/rg.210136