Nipple adenoma is a rare, benign breast lesion which often mimics a malignancy
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Clinical presentation
Patient presents with bloody discharge from an ulcerated and painful nipple in one breast. There is itching associated with this lesion. Symptoms may show variation with the menstrual cycle. There may be enlargement of the nipple and sometimes a mass may be palpated.
Epidemiology
Can occur in any age group but most often seen in the age group of 40-50 years. It is seen in both females and males (<5%).
Pathology
Gross pathology
A well circumscribed and unencapsulated lesion.
Microscopic
Glands with stromal fibrosis and epithelial hyperplasia.
Radiographic features
Mammogram
Usually small in size lesions, which are not picked up on ultrasound. If seen they are seen as an indistinct mass in the region of the nipple.
Ultrasound
Mostly seen as a small (0.5 -1.5 cm), well-circumscribed nodule in the superficial part of the nipple with homogeneous echogenicity. On Doppler these lesions are hypervascular. Doppler sonography may also aid in diagnosis since most of these entities are hypervascular.
Treatment and prognosis
It is believed to be a premalignant lesion. Complete excision with a narrow rim of uninvolved breast tissue is adequate treatment.