I am a girl of 19. My nipples are inverted since my childhood. Also I have 2small lumps in my both underarms from my small age itself. Those lumps are same in size doesn't give me any sort of disturbance. Bt I recently I came to hear that inverted nipples and lumps in underarm are signs of breast cancer .what should I do? Should I trust it? Is it possible to get rid of this issue. Is it possible for nipple to evert?

Dr. Nikhilesh BorkarOncologist14yrs exp

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Nipple inversion of recent onset is a sign of breast cancer. Axillary soft lumps are usually lipomas or more commonly accessory breasts, which are benign. They can be removed surgically if causing problems. In Breast cancer patients we see firm to hard Axillary nodes, which are due to spread of cancer from the breast. A congenitally inverted nipple is present in approximately 3 percent of women ages 19 to 26 without a history of infection, inflammation, trauma, tumor, periareolar surgery, or pregnancy. Congenital nipple inversion is benign and usually bilateral. The cause of congenital nipple inversion is a failure of the underlying tissue to proliferate and project the nipple papilla outward. In the majority of cases, the inverted nipple is umbilicated rather than invaginated There is clinical grading system for nipple inversion is based upon how difficult it is to pull the nipple out manually and how well projection is subsequently maintained: Grade I The nipple is easily pulled out with gentle squeezing of the areolar skin. Nipple projection is well maintained for several minutes, but then the nipple reverts to an inverted state. Grade II Forceful manipulation is required to pull the nipple out, and inversion recurs quickly as shown in the figure. The majority of patients with nipple inversion have grade II inversion. Grade III There is no projection of the nipple and the papilla is buried below the level of the skin. Despite maximal manipulation, the nipple cannot be pulled out and is described as invaginated. Although the majority of patients with nipple inversion have benign disease, some may wish to have correction of their inversion for cosmetic reasons or to improve the chances of being able to breast feed. It can be done by -Simple purse string suture around the base of nipple to prevent it from retracting, but works for low grade inversion. -Another method is to divide the fibrotic tissue between the ducts and selective ductal division if it is holding back the nipple with sutures taken at base to hold the nipple, works even with grade 3 inversion. - some have tried distraction techniques with good results in grade 1 and 2 inversion. Feel free to contact me directly if you want to discuss this further.  

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