Women's Health Community

Dear fortysomething: Yes, we do get questions about itchy nipples or burning nipples. The least common causes, but the most serious, would be inflammatory breast cancer or Paget's Disease (another type of breast cancer). Usually inflammatory breast cancer has visual changes such as redness in the surrounding tissue such that it can be mistaken for a breast infection. Paget's may have crusting that appears to be eczema; in more advanced stages the skin can look like orange peel. Here is information on Paget's from the National Library of Medicine site:

Cancer Treat Rev. 2001 Feb;27(1):9-18. Links Paget's disease of the breast.Sakorafas GH, Blanchard K, Sarr MG, Farley DR. Department of Surgery, 251 Hellenic Air Force General Hospital, GR--115 25 Athens, Greece. [email protected]

Paget's disease of the breast is a rare disorder of the nipple-areola complex that is often associated with an underlying in situ or invasive carcinoma. A change in sensation of the nipple-areola, such as itching and burning, is a common presenting symptom. Objectively, eczematoid changes of the nipple-areola complex are common. The later stages of Paget's disease of the breast are characterized by ulceration and destruction of the nipple-areola complex. Eczematoid changes of the nipple-areola complex and persisting soreness or itching, without obvious reason, is a suspicious symptom for Paget's disease of the breast and calls for thorough evaluation, including mammography. Exfoliative cytology with demonstration of Paget's cells may be useful, but a negative finding does not exclude Paget's disease of the breast. Surgical biopsy is the diagnostic standard and therefore the diagnosis should always be confirmed by open (surgical) biopsy. The histogenesis of Paget's disease of the breast continues to be debated. The epidermotropic theory holds that Paget's cells are ductal carcinoma cells that have migrated from the underlying breast parenchyma to the nipple epidermis. According to the in situ transformation theory, the Paget's cells arise as malignant cells in the nipple epidermis independent from any other pathologic process within the breast parenchyma. This theory has been proposed to explain those cases in which there is no underlying mammary carcinoma or when there is a carcinoma remote from the nipple-areola complex. Each of these theories is plausible; however, treatment approaches differ markedly depending on the theory of histogenesis. Mastectomy has been considered the standard of care in the management of patients with Paget's disease of the breast. Nowadays, however, some patients with Paget's disease of the breast are candidates for breast-conserving therapy. Patients must be selected carefully on an individual basis. Until there is a better understanding of the relationship of Paget's disease of the breast to the underlying cancer the surgeon should understand the natural history and behaviour of this lesion and be aware of both the risks of under- and over-treating patients with Paget's disease of the breast. Copyright 2001 Harcourt Publishers Ltd.

Many dermatology conditions can impact the nipple such as atopic dermatitis, allergic reaction to laundry products, psoriasis, or even Fox Fordyce syndrome (apocrine sweat glands become clogged). Rubbing of the nipple (eg jog bra syndrome) can start nerves firing inappropriately so that the sensation of irritation persists after the area has healed.

I would urge you to see your GYN for a focused breast exam. If indicated you could be referred to a breast specialist/breast surgeon--or a dermatologist.

Yours, Jane

The same this is happening to me! I found it odd, just the right nipple... itchy like poison ivy itch! Sometimes it will last throughout the day and night. It's been going on for a few months now. I just read the response below, which is disconcerting... since I'm about a year and a half late for my mammogram. I will make an appt. this morning.

I have the same problem --in the last month i've found that my nipples are very itchy and the area around the areola---its itchy on and off all day long --i've heard of Pagets but i do not have any crusting of the nipple or anything visable at all!! just the redness from me scratching....... i try not scratch because it just dosen't seem to do any good.... the itch dosen't go away --so iv'e basically been trying to ignore it. I have to get my mammogram done soon --I go in every January --I'm thinking now I should go early now .

Hi Gahlic. I am having the same problem. You noted that you were making an appt. I was wondering what you found out!

I have also been having the same problem for the last 3.5 weeks. Went to my doctor last week who figured it was eczema, but then I was researching online, found out that eczema on the nipple can be an indicator of breast cancer and read up on pagets disease of the nipple.

Went back today, doc couldn't find any lumps, but I'm going for a mammogram. I'm 46 this week, and understand there can be false positives with a mammogram at my age.

What worries me, is when I read about pagets, and it says a clear mammography isn't necessarily the all clear for cancer.

So now I'm wondering, if the mammogram comes back clear, should I still be worried or not?

I'm going through the same thing, although it has improved lately. I had a mammogram/MRI and have now gone to a breast surgeon who has sent me for an ultrasound. She thinks it might be Seborrheic Keratosis and gave me some cortisone cream. If that doesn't work she'll do a biopsy. Don't like that thought too much. What's your status?

Hi I am 45 yrs old and over the last couple weeks have found that my nipples are extremely itchy all the time. Anti itch cream helps for a short time but resently I was checking for discharge from my nipples wondering if I could have an infection in both breasts. I squeeze the nipple and get a thin green discharge. Not a lot but I am worried now if I could have an infection. I also don't see any discoloring, redness or any indication that there is anything wrong with my breasts.

I have not changed soaps, detergents or anything to think it could be allergies. But with the winter here I do feel all my skin dry and occationally itchy could there be that is why my nipples are itchy too? I have never had this before though and every winter I get the winter dry skin.

Here is my story, after 2.5 weeks of left nipple aureola itching soooo bad that I thought I might rip it off I contacted my breast care specialist. They got me in within a couple of days. My NP looked felt and decided that though she could not feel a lump my skin did not look right. Soooo on to mamo and ultrasound which shows no lumps/masses etc., but I am still itching and now it hurts under my nipple. Now I will have a MRI done and possibly a punch biopsy of the 'offending skin'. Something is just not right and may not be rearing it's ugly head yet. PLEASE, if you have symptoms call your DR. Jo

I am so happy to see so many of us have the same problem I thought I was loosing it...I have been dealing with an itchy nipple for about two and a half weeks now and feel like i'm going in sane...I noticed at times it don't itch as much and oh what a releif...I have also noticed though that the nipple erea burns I gues its from the rubbing...I am going to see my doctor on Tuesday next week and hoping she will not brush this off to being nothing... ...I am very scared to find out its cancer but the way I look at things is the quicker they find it the quicker they can fix it and my chances are much greater...I am very scared though..

Hi fortysomething1964 - what you described is exactly what I've been experiencing for over a year and a half. I've always had random skin problems, so just chalked this up to be another one. But after reading the response you received about Paget's disease, I immediately made an appt with my GYN. I'll be honest, I'm a little freaked out. Just curious, and if you don't mind sharing, have you come to a conclusion or diagnosis with your doctor?

Thanks for your help.

Hi Gahlic - I read your message about the Itchy Nipple and have the exact same problem - right side and all. If you don't mind me asking, have you reached a conclusion or diagnosis with your doctor?

Thanks for your help.

Have been experiencing this for several months now. Had my Mammo in early March and everything was fine. I am in the process of switching GYNs since the group I was going to most of the doctors (including the one I saw and loved) dropped out of my insurance. My skin does get very dry over the winter, but this is the first year that my nipples have itched for more than a day or two. My GP does not does this sort of thing, and I am not due for my Pap until July. Don't know if I can get in to see the new GYN before that, and I already had my records switched so I can't go back to the old GYN. Have had no redness, except due to scratching, and no discharge at all.

Any advice?

Hi, I am having the same symptoms/issues. I am 25 and have not had any health issues. Like one of your responders, I'm afraid that the doctor will easily brush it off as eczema or something like that. Have you gone to the doctor yet and if so what have they said? I'd love to hear it. thanks!

I am 46 and over the last month noticed my right nipple was itching occasionally and the skin below my nipple is crusty first thing in the morning. I have been putting cream on and have now noticed a small area on my left nipple too. The same thing happened once before but cleared up so i just assumed this would but it hasn't so far. I think i'll make an appointment with the GP because its better to be safe than sorry isn't it?

I've found it somehow comforting to know that i'm not the only one who has these symptoms and that actually it seems fairly common.