Painful Nodules on the Nipple: When to Seek Medical Advice

A growth on the nipple resembling a sebaceous cyst?

Hello doctor, I have a polycystic condition and elevated male hormones, which makes me prone to acne and sebaceous cysts.
In the past, I had a sebaceous cyst in my breast (which was not painful and I showed it to a doctor), but this time it has developed on my nipple and it hurts when it rubs against my clothing.
I can feel a round, soft lump inside, and because it is on the nipple where the skin is thin, I can see a bit of white in the middle.
After about five days, it became painless to touch lightly, but applying pressure causes a sensation similar to that of a pimple about to burst, yet it hasn't gone away.
Since it is on my nipple, I find it a bit concerning and I'm worried it might be something serious.
I found information online that resembles Montgomery gland inflammation, but that occurs on the areola, not the nipple.
I would like to ask the doctor if this situation could be something serious? Should I see a doctor promptly, or can I just monitor it as long as it doesn't grow or become painful?

Xiao Jie, 20~29 year old female. Ask Date: 2022/07/09

Dr. Yuan Tianmin reply Breast and Thyroid

You should go for an examination by a specialist in breast diagnostics.

Reply Date: 2022/07/09

More Info

When it comes to painful nodules on the nipple, it is essential to approach the situation with caution and awareness. Based on your description, it seems you have a history of developing cysts and acne due to hormonal imbalances, which can lead to the formation of similar nodules. However, the specific characteristics of the nodule you described—its location on the nipple, the pain associated with friction, and the soft, round feel—warrant careful consideration.

Nodules on the nipple can arise from various causes, including benign conditions such as Montgomery glands' inflammation, cysts, or even infections. Montgomery glands are specialized sebaceous glands located around the areola that can become inflamed or blocked, leading to painful lumps. However, since your nodule is located directly on the nipple and has not resolved after five days, it is prudent to seek medical advice.

Here are some key points to consider regarding your situation:
1. Duration and Symptoms: While some benign conditions can resolve on their own, a nodule that persists for more than a few days, especially if it is painful or changing in size, should be evaluated by a healthcare professional. The fact that you experienced pain when pressing on it, akin to the sensation of a pimple ready to burst, suggests that it may be inflamed or infected.

2. Physical Examination: A healthcare provider will perform a thorough examination, which may include palpation of the nodule and surrounding tissue. They may also inquire about any additional symptoms, such as changes in breast tissue, discharge from the nipple, or systemic symptoms like fever.

3. Imaging Studies: Depending on the findings during the physical examination, your doctor may recommend imaging studies, such as an ultrasound, to assess the nodule's characteristics further. This can help differentiate between a benign cyst and other potential issues.

4. Potential Treatments: If the nodule is determined to be a benign cyst or an inflamed Montgomery gland, treatment options may include warm compresses, anti-inflammatory medications, or, in some cases, drainage if there is an abscess. If there is any suspicion of a more serious condition, further diagnostic procedures may be necessary.

5. When to Seek Immediate Care: If you notice any of the following symptoms, you should seek medical attention promptly:
- Rapid growth of the nodule
- Persistent pain that worsens
- Discharge from the nipple that is bloody or has an unusual color
- Any signs of infection, such as redness, warmth, or fever
In conclusion, while your previous experiences with cysts may provide some reassurance, the specific characteristics of this new nodule on your nipple, combined with your hormonal background, suggest that it is wise to consult a healthcare professional. They can provide a proper diagnosis and treatment plan tailored to your needs. Early evaluation is always preferable to ensure peace of mind and address any potential issues before they escalate.

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