What Does It Mean When the Nipple or Areola Itches?
Some patients may not yet have a palpable lump in the breast but only experience itching or rash on the nipple or areola, resembling eczema. In fact, this could be a special type of cancer known as Paget’s disease, or eczematoid breast cancer. Therefore, minor changes should not be overlooked.
Of course, eczematous changes on the nipple or areola are not always due to cancer—some cases are simply simple eczema. So, what situations should raise particular concern? Generally speaking, if there is an eczematous change on one side of the nipple or areola that persists without healing, the likelihood of eczematoid carcinoma is high. The main features include initial severe itching or mild burning sensation, followed by redness of the skin around the nipple and areola, mild erosion, and yellowish-brown or gray scaly crusts adhering to the surface. The skin in the affected area becomes coarse, thickened, and hardened, clearly demarcated from surrounding tissue. Later, the affected nipple may become inverted, eroded, or ulcerated, and a hard mass may be felt within the breast.
In the early stage of eczematoid breast cancer, when the lesion is limited to the nipple and areola and no mass can yet be felt in the breast, simple excision of the affected breast yields relatively good results. However, once a breast mass has formed, the prognosis is poor, requiring radical mastectomy. Therefore, timely diagnosis and treatment during the initial stage of eczematous changes on the nipple and areola is crucial for achieving a favorable outcome. Clinically, any skin lesion on the nipple or areola unresponsive to treatment after two weeks should prompt biopsy for definitive diagnosis.<Breast>