Inverted nipples
Introduction
Introduction to nipple retraction The nipple of a female breast does not protrude from the plane of the areola, and even if it is recessed under the surface of the skin, causing a local crater shape, called craternipple, is a more common female breast deformity. The proportion of women with nipple depressions is as high as 40%. There are two cases of nipple retraction: the nipple retreating or turning into the breast, and pulling the skin is not higher than the skin of the breast, called the true nipple retraction; the nipple develops normally and falls into the areola, the nipple and the skin are in the same plane, but can not Those who erect, who are pulled out as ordinary people, call the pseudo nipple retracted. True nipple retraction is common on both sides, primary or hereditary; unilateral nipples are less invaginated, usually secondary to breast disease. basic knowledge The proportion of illness: 1% to 2% (the incidence of female nipple retraction is 1% to 2%) Susceptible people: women Mode of infection: non-infectious Complications: acute mastitis
Cause
Cause of nipple retraction
Smooth muscle dysplasia of primary nipples and areola (35%):
The nipple has 15 to 20 openings for the milk duct, and there are smooth muscle fibers around the lactiferous duct. The invaginated nipple is pulled inwardly around the milk duct and the muscle fiber bundle inserted into the dermal dermis. The texture of these muscle bundles and the lactiferous duct There are significant differences.
The primary lactifera itself is underdeveloped (30%):
Incompletely developed ductal ducts fail to be catheterized as a cord. The lack of support for tissue under the nipple is also the cause of nipple retraction.
Other factors (30%):
Tumors that are usually secondary to the breast, inflammation, trauma, or scarring after breast surgery, or large breast sagging.
Pathogenesis
1. Pathogenesis: Primary nipple retraction is a developmental malformation. Due to the ectoderm at the beginning of the nipple development, the ectoderm of the initial part of the nipple is concave to form the deciduous fossa, and then the lower mesenchyme accelerates to form a nipple. When this process is stagnant, the invagination of the nipple is formed, and a quarter of the patients are bilateral, and the secondary nipple retraction is mostly caused by the nipple being pulled by the pathological tissue in the breast, resulting in the nipple not protruding and forming. Often one of the clinical signs of inflammation in the breast, especially breast cancer.
2. Pathological degree: The depth of nipple retraction can be divided into 3 degrees according to its depth of retraction:
First degree: the nipple is slightly retracted, and the nipple base has a depression.
Second degree: The nipple is moderately retracted and the nipple has fallen into the areola.
The third degree: the nipple is severely retracted, folded and recessed, and the glove is inverted. It is the result of cancer cells invading the areola area and contracting the fibrous tissue.
Prevention
Nipple repression prevention
First, any woman among mothers, aunts and other immediate family members who have nipple retraction should be the focus of prevention. After a baby girl with a genetic predisposition, the mother can gently lift the small nipple outward one or two times a day. Be careful that the action must be gentle. It is best to have an experienced person. In this way, it can be seen that the baby's nipple is mung bean-like or small rounded shape higher than the skin, and the chance of nipple retraction in the future is greatly reduced.
Second, pay attention to clothing. Intimate underwear should be cotton products, and often wash and sunlight. If there are signs of redness or cracking in the nipple, the underwear should be cooked and sterilized. It is not too early for the girl to use the bra.
Third, prevent extrusion. Underwear, bras are appropriate, not too tight, for girls with larger breasts, should pay more attention to the looseness of the breasts. For girls with prone habits, they should be corrected in time to prevent the nipple from being squeezed, so as not to increase the degree of nipple retraction.
Fourth, after giving birth to a woman with nipple retraction, special attention should be paid to the health and hygiene of the nipple. Hangzhou nipple retraction correction expert said that the nipple has a slight depression, appropriately increase the number of sucking of the baby, while paying attention to the protection of the nipple, pay attention to cleaning after breastfeeding, beware of infection. Once the nipple is swollen, you should go to the hospital for treatment to prevent mastitis.
Complication
Nipple invagination complications Complications acute mastitis
1. Local infection: nipple retraction makes local cleaning difficult, easy to accumulate dirt and secondary infection, causing chronic inflammation, local accumulation of exudate often, may have bad odor, can cause local skin erosion.
2. Difficulties in breastfeeding: nipple retraction makes breastfeeding impossible, milk deposition, and even acute mastitis caused by secondary infection.
3. The invagination affects the appearance and needs to be shaped.
Symptom
Symptoms of nipple retraction common symptoms can be licked and deep edema in the areola
One or both nipples retract below the skin of the breast. If there is ductal mastitis, there may be erythema and pain around the areola of the patient, and the mass may be touched under the areola. If it is secondary to breast cancer, the affected breast may still have orange peel. Like, armor-like skin lesions.
Examine
Nipple retraction examination
1. X-ray examination of mammography: axial mass can be found in breast mass, fibrosis and calcification lesions.
2. MRI examination: The nipple can be displayed when the fat resists scanning.
Diagnosis
Diagnosis and identification of nipple retraction
diagnosis
1. History: Primary nipple retraction occurs in adolescent girls, secondary nipple retraction, more common in lactating women, due to ductal dilatation or breast ductal mastitis, breast tumor with breast mass And corresponding skin lesions.
2. Clinical manifestations: It is the main basis for diagnosis, that is, one or both nipples retreat into the skin of the breast, or varus in the breast.
Differential diagnosis
It should be differentiated from breast cancer, which will lead to changes in breast skin and contour: Cooper ligaments invading the skin can form a "dimple sign"; tumor cells block the subcutaneous capillary lymphatic vessels, causing skin edema, and the follicles are depressed to form "orange peel sign" ".
