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Ask Mrs. E Brush Your Own Question
Mrs. E Brush
Mrs. E Brush, Nurse
Category: Health
Satisfied Customers: 675
Experience:  RN, CNA II, BLS-CPR certified, Ordination current, Author of "In Exchange for Grace"
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My friend has a lump on the side of her nipple. When ...

Customer Question

My friend has a lump on the side of her nipple. When she squeezes it, it has a white seed / string like core and is painful. What is this?
Submitted: 9 years ago.
Category: Health
Expert:  Mrs. E Brush replied 9 years ago.

Hello. Is this a part of the nipple (you state it is on the side, do you mean that it is actually on the areola?)? or is it beside the nipple in the skin/breast?

How long has this been there? When you say it 'keeps coming back' does that mean it resolves completely and then reoccurs?

Is it getting worse when it recurs or staying the same?

Customer: replied 9 years ago.
Reply to Mrs. E Brush's Post: It is at the base of the nipple on the areola. It started after I quit nursing about 8 yrs ago and was small like a pimple. At that time it was not hard and after I would squeeze it, it would be completely gone for about a month and then come back. Over the year it has turned hard, gets larger (about the size of a pencil eraser, and is very hard and painful to pop. It used to have a soft white pimple like filling to it. Now it is a hard seedlike core followed by a white string like filling. It no longer goes away for awhile like it used to because I can no longer squeeze everything out of it. It causes tenderness to the touch of my nipple or areola. Also over the last few months, at the cyst of the cyst, the skin is dry and flakes slightly every so often.
Expert:  Mrs. E Brush replied 9 years ago.

Thank you for the clarification. What you are describing is a blocked duct. Around the areola are sebaceous glands known as Montgomery's tubercle. When these become blocked or infected, the pimple-like cyst that you describe can occur. This will usually resolve on it's own- however, you describe this as a problem that has been consistant over eight years (quite a long time) and so I would advise physical evaluation and a swab/culture of the 'filling'. This can advise the doctor as to an appropriate antibiotic treatment prescription that can resolve this for you. Additionally, the flakiness that you describe is probably related and may indicate that this could be related to a type of yeast overgrowth in the area. Because of this, physical evaluation is definately necessary to prescribe appropriate treatment.

I hope this is helpful to you and you seek the evaluation that you need- please remember to press accept and feel free to contact me if you have anything to add.

Mrs. E Brush and 4 other Health Specialists are ready to help you
Expert:  Mrs. E Brush replied 9 years ago.
Is there anything else I can help you with?
Customer: replied 9 years ago.
Reply to Mrs. E Brush's Post: So you don't believe that this is Paget's disease (the flaking) or a type of cancer in the milk duct?
Expert:  Mrs. E Brush replied 9 years ago.

No, I don't believe that this is related to either paget's disease or cancer. However, physical examination is necessary to completely rule the possibility of cancer out and diagnosis can't really be made based on a description of symptoms.

The reason I don't think it is Pagets/cancer is because with these, the symptoms usually start with the nipple and then move the areola. What you describe is only an areola involvement. The symptoms of of Pagets/cancer include an eczema-like rash, not just the flakeyness (like with yeast overgrowth, true eczema or dermatitis). The skin of the nipple and areola can appear red and inflamed. There may also be crusting, bleeding and ulceration, which is a bit more dramatic than what you describe. Some women have an itching or burning sensation. Fluid (discharge) may leak from the abnormal area of cells. The nipple may turn inwards (be inverted). Many times a breast lump will be palpable by the time these symptoms arise as well.

All of that being said, you should be preforming monthly self breast exams and a mammogram if over 40. I do suggest that although I don't suspect cancer, you should have this evaluated by your doctor for infection intervention and to be completely sure.

Customer: replied 9 years ago.
Thank you. I will follow up with my doctor, but am glad to hear that you don't believe it paget's or cancer. I think I had been putting it off being I was scared to hear the worse. I will definitely follow up on it though. Again, thank you.
Expert:  Mrs. E Brush replied 9 years ago.
You're very welcome, that's what we are here for. Because the infection seems be getting worse (and really isn't resolving after 8 years!) I do think you need physical evaluation by your doctor so you can get the right prescription to go ahead and resolve it so it doesn't get worse. I'm glad to hear you will be following up.