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Adenoma of Nipple

British Journal of Cancer
Nature Publishing Group
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187 ADENOMA OF NIPPLE R. S. HANDLEY AND A. C. THACKRAY From the Middlesex Hospital and Bland-Sutton Institute of Pathology, London, W.1 Received for publication April 30, 1962 CRUSTING and eczema of the nipple, with or without occasional bleeding, have long been thought to indicate Paget's disease. Identical symptoms and signs may be caused by a benign lesion which, though its clinical features are confusing, has a characteristic histological appearance. It is the purpose of this paper to describe this benign lesion under the name of " Adenoma of the Nipple ". Clinical Features The following account has been compiled from the case histories of the nine patients who have come to our notice. Patients with adenoma of the nipple most frequently complain of soreness of the affected nipple, bloody discharge and scab formation. They may also suffer from irritation, actual pain, blister formation or may discover a lump in the nipple. These symptoms are often more troublesome just before the onset of a period and they interfere seriously with the feeding of infants. The symp- toms are of long duration, the shortest history among our patients being of 15 months and the longest of 11 years, with an average of 5-1 years. Adenoma of the nipple occurs at a somewhat younger age than does Paget's disease, the average age of our patients at operation being 39 years, or 331 years at the time of onset. On examination the appearances vary from a nipple which is normal until examined in an exacerbation to one which shows the classical signs of an early Paget's disease. The nipple may be ulcerated or eczematous and crusted. It may be obviously swollen, or only apparently larger than its fellow. A lump may be palpable in the nipple, or protrude from its surface, or the whole nipple may be hard; the ulcer may take the form of a fissure. The condition in fact cannot certainly be distinguished on clinical grounds from Paget's disease. Case Histories Case 1.-Miss H. H. (Msx. Hosp. Reg. No. A 27382), was admitt

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