Eczema or Breast Cancer. Know the signs.
Eczema of the nipple must be evaluated very carefully. If it only involves one nipple and the person is not breastfeeding, one should always be suspicious of breast cancer. This lady has complained of itching on one areola. On examination, you can feel that one areola is harder than the other, and you can see it retracting (pulling) inward at rest. That retraction becomes more evident when you gently squeeze the skin around the areola. (to see the full video, please go to our YouTube channel).
My general rule is if I suspect eczema to be the cause of the nipple and areola itch and rash, I give a topical steroid for one month. If the rash and symptoms don't clear in one month or they keep returning to that area, I recommend a biopsy to make sure it is not breast cancer.
In this diagram, you can see one of the types of breast cancer. This type called ductal breast cancer, begins in the breast ducts that exit onto the nipple and areola, and thus, if they are involved with cancer they will drain and collect at the skin of the nipple and areola. Eventually, as shown in this illustration, the breast cancer will exit the duct lumen, becoming invasive, further spreading to the lymph nodes, and causing metastases. It is paramount that we catch it as early as possible to avoid metastases, and in this form of cancer, the skin itch or “Eczema” may be the first sign of breast cancer, as we say at our center. Your “Health and Beauty is our duty.” Be good, do good, and may good come your way.
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