EpistemisUnilateral retraction of the nipple or breast skin
Specialty: Gynecology and breast.
Why it occurs
- Infiltrating ductal or lobular carcinoma (due to shortening of Cooper's ligaments due to tumor invasion)
- Severe ductal ectasia with periductal fibrosis
- Sequela of breast trauma with underlying fat necrosis
- Chronic mastitis or resolved retroareolar abscess with scarring fibrosis
- Previous breast surgery
Initial workup
Immediate bilateral diagnostic mammography complemented by breast ultrasound directed at the quadrant and retroareolar plane. Breast MRI with contrast if previous studies are inconclusive. Core needle biopsy (CNB) or vacuum-assisted biopsy (VAB) of any detected solid lesion or area of tissue distortion underlying retraction.
red flags
Retraction of new appearance, asymmetrical, unilateral, that cannot be everted by gentle manipulation, of rapid progression, associated with local skin thickening, induration of the areola, axillary or supraclavicular lymphadenopathy of stony consistency.
Standard management
- There are no drugs indicated for this symptom. If malignant tumor etiology is confirmed, the specific oncological protocol is initiated (neoadjuvant chemotherapy, hormonal therapy or oncological surgery depending on the molecular subtype). Specific antibiotic treatment if associated with active mastitis or underlying abscess.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Gynecology and breast
- Listed causes
- 5
- Treatment options
- 1