Annals of Surgical Oncology

, Volume 22, Issue 10, pp 3236–3240 | Cite as

A Review of Anatomy, Physiology, and Benign Pathology of the Nipple

  • Kimberly Stone
  • Amanda WheelerEmail author
Breast Oncology


The nipple and areola are pigmented areas of modified skin that connect with the underlying gland of the breast via ducts. The fairly common congenital anomalies of the nipple include inversion, clefts, and supernumerary nipples. The anatomy of the nipple areolar complex is discussed as a foundation to review anatomical variants, and the physiologic development of the nipple, including changes in puberty and pregnancy, as well as the basis of normal physiologic discharge, are addressed. Skin conditions affecting the nipple include eczema, which, while similar to eczema occurring elsewhere on the body, poses unique aspects in terms of diagnosis and treatment. This article concludes with discussion on the benign abnormalities that develop within the nipple, including intraductal papilloma and nipple adenoma.


Atopic Dermatitis Nipple Nipple Areolar Complex Nipple Discharge Intraductal Papilloma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Special thanks to Stefanie Jeffrey, MD, for her thoughtful edits, as well as Fred Dirbas, MD, and Irene Wapnir, MD, and to Barbara L. Smith, MD, PhD, for her permission to use Fig. 2, and her groundbreaking work on nipple anatomy.


Kimberly Stone and Amanda Wheeler have no disclosures to declare.


  1. 1.
    Wheeler A. Nipples gone bad. The American Society of Breast Surgeons 16th Annual Meeting; 29 April–3 May 2015: Orlando.Google Scholar
  2. 2.
    Sanuki J, Fukuma E, Uchida Y. Morphologic study of nipple-areola complex in 600 breasts. Aesthetic Plast Surg. 2009;33:295–297.CrossRefGoogle Scholar
  3. 3.
    Nicholson BT, Harvey JA, Cohen MA. Nipple areolar complex: normal anatomy and benign and malignant processes. Radiographics. 2009;29:509–523.CrossRefPubMedGoogle Scholar
  4. 4.
    Kopans DB. Breast anatomy and basic histology, physiology, and pathology. In: Kopans DB, editor. Breast Imaging. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007: pp. 7–43.Google Scholar
  5. 5.
    Da Costa D, Taddese A, Cure ML, Gerson D, Poppiti R Jr, Esserman LE. Common and unusual diseases of the nipple-areolar complex. Radiographics. 2007;27(Suppl 1):S65–S77).CrossRefPubMedGoogle Scholar
  6. 6.
    Rapini RP, Bolognia JL, Jorizzo JL. Dermatology: 2-volume set. St. Louis: Mosby; 2007. ISBN 1-4160-2999-0.Google Scholar
  7. 7.
    Levin RJ. The breast/nipple/areola complex and human sexuality. Sex Relatsh Ther. 2006;21(2):237–249.CrossRefGoogle Scholar
  8. 8.
    Skandalakis J. Breast. In: Skandalakis J, editor. Skandalakis’ surgical anatomy: the embryologic and anatomic basis of modern surgery. Athens: PMP; 2004. pp. 106–107.Google Scholar
  9. 9.
    Palmer JH, Taylor GI. The vascular territories of the anterior chest wall. Br J Plast Surg. 1986;39:287–99.CrossRefPubMedGoogle Scholar
  10. 10.
    Going JJ, Moffat DF. Escaping from flatland: clinical and biological aspects of human mammary duct anatomy in three dimensions. J Pathol. 2004;203(1):538–44.CrossRefPubMedGoogle Scholar
  11. 11.
    Love SM, Barsky SH. Anatomy of the nipple and breast ducts revisited. Cancer. 2004;101(9):1947–57.CrossRefPubMedGoogle Scholar
  12. 12.
    Cooper A. The anatomy and diseases of the breast. Philadelphia: Lea and Blanchard; 1845.Google Scholar
  13. 13.
    Rusby JE, Brachtel EF, Michaelson JS, Koerner FC, Smith BL. Breast duct anatomy in the human nipple: three-dimensional patterns and clinical implications. Breast Cancer Res Treat. 2007;106:171.CrossRefPubMedGoogle Scholar
  14. 14.
    Love SM, Lindsey K. The breast and its development. In: Love SM, Lindsey K. Dr, editor. Susan love’s breast book. 2nd ed. Reading: Addison-Wesley; 1995: pp. 3–18.Google Scholar
  15. 15.
    Chinyama CN. Normal morphology, physiological changes, and benign breast disease. In: Dirbas F, Scott-Conner C, editors. Breast surgical techniques and interdisciplinary management. New York: Springer; 2011: pp. 65–81.Google Scholar
  16. 16.
    Spencer J. Common problems of breastfeeding and weaning. In: Post TW, editor. UpToDate®: Waltham. Accessed 14 May 2015.
  17. 17.
    Fontainebleau School. Presumed portrait of Gabrielle D’Estrées and her sister, the Duchess of Villars (c. 1594) [painting]. Musee Du Louvre, Paris, France. Nipple-Pinching Good Times. Tumblr, 2009. Accessed 29 May 2015.Google Scholar
  18. 18.
    Harris JR, Lippman M, Morrow M, et al. Diseases of the breast. 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2010.Google Scholar
  19. 19.
    Da Costa D, Taddese A, Cure ML, Gerson D, Poppiti R Jr, Esserman LE. Common and unusual diseases of the nipple-areolar complex. Radiographics. 2007;27 Suppl 1:S65–S77.CrossRefPubMedGoogle Scholar
  20. 20.
    Shah AK, Floyd D. The congenital cleft nipple and its surgical treatment. J Plast Reconstr Aesthet Surg. 2012;65(4):e75-9.CrossRefPubMedGoogle Scholar
  21. 21.
    Newson A (2005). Bond villain’s nipple triple gives clues to breast cancer treatment. Times Online. Times Newspapers.Google Scholar
  22. 22.
    Barankin B, Gross MS. Nipple and areolar eczema in the breastfeeding woman. J Cutan Med Surg. 2004;8:126–130.CrossRefPubMedGoogle Scholar
  23. 23.
    Disorders of the nipple and areola. In: Mansel RE, Webster DJT, Sweetland HM. Hughes, Mansel & Webster’s benign disorders and diseases of the breast. 3rd ed. Elsevier; 2009: pp. 195–205.Google Scholar
  24. 24.
    Chen CY, Calhoun KE, Anderson BO. Paget’s disease of the breast. In: Dirbas F, editor. Breast surgical techniques and interdisciplinary management. New York: Springer; 2011. pp. 533–534.Google Scholar
  25. 25.
    Giess CS, Raza S, Birdwell RL. Distinguishing breast skin lesions from superficial breast parenchymal lesions: diagnostic criteria, imaging characteristics, and pitfalls. Radiographics. 2011;31(7):1959–72.CrossRefPubMedGoogle Scholar
  26. 26.
    MacGrogan G, Moinfar F, Raju U. Intraductal papillary neoplasms. In: Tavassoli FA, Devilee P, editors. World Health Organization classification of tumours: pathology and genetics of tumours of the breast and female genital organs. Lyon: IARC Press; 2003. pp. 76–88.Google Scholar
  27. 27.
    Lannin D. Twenty-two year experience with recurring subareolar abscess and lactiferous duct fistula treated by a single breast surgeon. Am J Surg. 2004;188:407–410.CrossRefPubMedGoogle Scholar
  28. 28.
    Schafer P, Furrer C, Mermillod B. An association of cigarette smoking with recurrent subareolar breast abscess. J Epidemiol. 1988;17:810–813.Google Scholar
  29. 29.
    Jones DB. Florid papillomatosis of the nipple ducts. Cancer. 1955;8(2):315–319.CrossRefPubMedGoogle Scholar

Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  1. 1.Department of SurgeryStanford University School of MedicineStanfordUSA

Personalised recommendations