ĭisorders of the breast in young women are generally benign. Although the coexistence of nipple adenoma and ipsilateral or contralateral breast cancer has been reported, this association is difficult to establish. Local recurrence is not infrequent, especially in the case of incomplete excision. Treatment of choice consists of complete surgical excision to prevent local recurrence, other treatments include Mohs micrographic surgery, nipple splitting enucleation technique, cryotherapy, or radiofrequency. Histologically, nipple adenomas show an irregular ductal proliferation within nipple stroma without significant cellular atypia. Dermoscopy in combination with histopathologic studies can be useful for accurate diagnosis. The key to obtaining early diagnosis and assessment for concomitant malignancy is represented by multimodality radiological evaluation employing mammography, ultrasonography, or breast MRI. Nipple adenoma can be misdiagnosed clinically as a malignant nipple lesion (like mammary Paget’s disease ), histologically as intraductal carcinoma.

A palpable mass of the nipple associated with nipple discharge and erosion or ulceration is the common clinical presentation. Nipple adenoma is a rare benign breast proliferative process of lactiferous ducts that usually affects middle-aged women. Moreover, conservative local treatment of nipple adenomas can preserve the nipple aesthetically and functionally, thus allowing regular lactation and breastfeeding in young women. Therefore, we consider that nipple adenoma enucleation might be a safe treatment even during pregnancy. The patient gave birth, had no deficit in lactation, and successfully breastfed. A histopathological examination confirmed the diagnosis. Surgical excision of nipple adenoma without complete resection of the nipple was performed after her first trimester of pregnancy under local anesthesia. Because of the volume and the position of the adenoma, the indication for surgical excision was confirmed, to allow regular lactation and breastfeeding immediately after giving birth and to avoid potential obstructive complications.

Taking into account the major risks of surgery during pregnancy, a multidisciplinary discussion was conducted, to consider whether to proceed with surgery or postpone it after pregnancy. After surgical treatment was recommended, the patient got pregnant. The diagnostic assessment came out in favor of a nipple adenoma.

We present the case of a 28-year-old female, who was referred to the Breast Unit of the University Hospital of Modena (Italy) in May 2020 with a 12-months history of enlargement of the left nipple with associated erythema, serohemorrhagic discharge, and pain in the left nipple region. Even if the management during pregnancy is usually conservative and surgical excision is reserved for very strong malignancy suspicion, benign lesions can cause the impossibility to breastfeed after giving birth when involving the nipple. Disorders of the breast in young women are generally benign. Generally, complete surgical excision of the nipple is the main treatment, alternative therapeutic methods such as Mohs micrographic surgery, nipple splitting enucleation, and cryotherapy can be considered. Nipple adenoma is a very uncommon, benign neoplasm that involves the nipple.

Growth on nipple during pregnancy